IRS FORM 1094-B

Version 4.3 by steveny on 2023/05/04 15:09

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