IRS FORM 1094-B

Last modified by Derek K on 2024/02/07 22:29

FORM 1094-B

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Part IV: Covered Individuals (Continuation)

Line 1, Filer's Complete Name

Line 2, Filer's EIN

Lines 3 and 4, Contact Person's Name and Telephone Number

Lines 5-8, Filer's Complete Address

Line 9, Total number of 1095-B forms transmitted with 1094-B

Related Pages:

IRS Forms 1095-C

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IRS Forms 1094-C

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IRS Forms 1095-B

Learn more about the IRS Form 1095-B.