Page 14 - 2026 Tax Catalog
P. 14

ACA RECIPIENT FORMATS                                                                                           14


        ACA Recipient Formats



        Order in increments of 25


        ACA RECIPIENT FORMATS
        The following forms have been developed to simplify
        the process of issuing and mailing recipient copies .
        These forms cannot be filed with the IRS. Check
        with your software for compatibility . Order 1 form per
        employee/insured .


        1095-B
        Item #      Description               Form Type
        B95BFPREC05   1095-B Full Page Recipient Form
                    w/Instructions on Back   Preprinted Laser
        B95BPERFI05   1095-B Form w/Instructions on Back   Blank Laser
        B95BLANK    1095 w/Fold Perforation    Blank Laser
        81650*      Pressure Seal 14" EZ 1095-B or   Blank
                    1095-C                   Pressure Seal   1095-B Full Page Recipient Form    1095-C Full Page Recipient Form
                                                             w/Instructions on Back         w/Instructions on Back
        1095-C                                               B95BFPREC05                    B95CFPREC05
        Item #      Description               Form Type
        B95CFPREC05   1095-C Full Page Recipient Form
                    w/Instructions on Back    Preprinted Laser
        B95CHPREC05   1095-C Half Page Recipient Form
                    w/Instructions on Front    Preprinted Laser                                    Instructions Here
        95CRCBT     1095-C Blank Top Half Page Recipient
                    Form w/Instructions on Back   Preprinted Laser
        B95CPERFI05   1095-C Form w/Instructions
                     on Back                  Blank Laser
        B95BLANK    1095 w/Fold Perforation    Blank Laser
        PS95CISB*   Pressure Seal 14" EZ Fold 1095-C    Blank
                    w/Instructions on Back   Pressure Seal
        81652*      Pressure Seal 14" EZ Fold 1095-C    Preprinted                                 Instructions Here
                                             Pressure Seal
        81650*      Pressure Seal 14" EZ 1095-B or   Blank
                    1095-C                   Pressure Seal
        *Order in increments of 500.
                                                             1095-C Half Page Recipient Form    Blank 1095-C Form w/Instructions
                                                             w/Instructions on Front        on Back
                                                             B95CHPREC05                    B95CPERFI05













                          COMPATIBLE
                          ENVELOPES
                          SEE PAGE 15.





                                                                            Eccentric Z-Fold


                                                                                            1095-C Preprinted Pressure Seal
                                                                                            14" EZ Fold
                                                                                            81652
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