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TF5097 2019 Laser Blank ACA 1095 with Backer 8 1/2 X 11"

Manufacturer: NEBS
Manufacturer Part No: TF5097
TF5097 2019 Laser Blank ACA 1095 with Backer
Size: 8 1/2 X 11"

Meet your reporting requirements under the Affordable Care Act (ACA).
  • Blank form with backer functions as 1095B or 1095C when your software prints the entire front side.
  • Black ink imprint
  • Laser form
  • 1 filing per sheet.
  • Packaged in quantities of 100.
  • One page with backer information per form.
  • Compatible with laser or inkjet printers.
  • This form is not available in multiple copies.  You must order for the total number of copies you need (ex. 50 employees - in most cases you will need one copy for the employee, one for the employer, and one for the IRS so you must order quantity 150).
  • 100% Satisfaction Guarantee.
  • Higher quantities are available at discounted prices.
  • Speak to a customer service specialist at 855-5FORMS5 or 855-536-7675. 8AM - 7PM EST Monday - Thursday and 8AM - 5PM EST on Friday.


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Starting at $16.20

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$16.20 TF5097 2019 Laser Blank ACA 1095 with Backer 8 1/2 X 11"

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