Wiki source code of IRS FORM 1094-C
Version 2.2 by steveny on 2023/05/04 15:21
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| author | version | line-number | content |
|---|---|---|---|
| 1 | == FORM 1094-C == | ||
| 2 | |||
| 3 | ===== [[image:/xwiki/bin/download/Windows/U.S./Affordable%20Care%20Act%20%28ACA%29%20%C2%BB/IRL%20Forms/IRS%20FORM%201094-C/WebHome/1.png?rev=1.1||alt="1.png"]]//Click on the individual boxes below for specific IRS Instructions | ||
| 4 | \\[[image:attach:1.png]]// ===== | ||
| 5 | |||
| 6 | ===== ===== | ||
| 7 | |||
| 8 | |**Part I: Applicable Large Employer Member (ALE Member)** | ||
| 9 | |((( | ||
| 10 | |[[Line 1, Name of ALE Member (Employer)>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e630]] | ||
| 11 | |[[Line 2, Employer Identification Number (EIN)>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e635]] | ||
| 12 | |[[Lines 3-6, Employer's Complete Address>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e646]] | ||
| 13 | |[[Lines 7 and 8, Contact Person's Name and Telephone Number>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e651]] | ||
| 14 | |[[Line 9, Name of Designated Government Entity (DGE)>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e668]] | ||
| 15 | |[[Line 10, Employer Identification Number (EIN) of Designated Government Entity (DGE)>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e673]] | ||
| 16 | |||
| 17 | |[[Lines 11-14, Designated Government Entity's (DGE) Complete Address>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e684]] | ||
| 18 | |[[Lines 15 and 16, Contact Person's Name and Telephone Number>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e689]] | ||
| 19 | |[[Line 17, Line reserved for future use>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e694]] | ||
| 20 | |[[Line 18, Total number of Forms 1094-C submitted with this transmittal>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e699]] | ||
| 21 | |[[Line 19, Authoritative Transmittal>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e704]] | ||
| 22 | ))) | ||
| 23 | |||
| 24 | |**Part II: ALE Member Information** | ||
| 25 | |[[Line 20, Total Number of Forms filed by and/or on behalf of the employer.>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e722]] | ||
| 26 | |[[Line 21, ALE Member is part of Aggregated ALE Group>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e727]] | ||
| 27 | |[[Line 22, Certifications of Eligibility>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e741]] | ||
| 28 | |||
| 29 | [[image:attach:2.png]] | ||
| 30 | |||
| 31 | |||
| 32 | |**Part III: ALE Member Information — Monthly (Lines 23–35)** | ||
| 33 | |[[Column (a), Minimum Essential Coverage>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e883]] | ||
| 34 | |[[Column (b), Full-Time Employee Count for ALE Member>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e966]] | ||
| 35 | |[[Column (c), Total Employee Count for ALE Member>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e980]] | ||
| 36 | |[[Column (d), Aggregated Group Indicator>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e988]] | ||
| 37 | |[[Column (e), Aggregated Group Indicator>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e996]] | ||
| 38 | |||
| 39 | [[image:attach:3.png]] | ||
| 40 | |||
| 41 | |||
| 42 | |**Part IV: Other ALE Members of Aggregated ALE Group** | ||
| 43 | |[[Lines 36-65, Other ALE Members of Aggregated ALE Group>>url:https://www.irs.gov/instructions/i109495c/ar01.html#d0e1001]] |