Page 15 - Taxforms

ACA RECIPIENT FORMATS

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
81651* Pressure Seal 14" EZ 1095-B Preprinted
w/Instructions on Back Pressure Seal 1095-B Full Page Recipient Form 1095-C Full Page Recipient Form
81650* Pressure Seal 14" EZ 1095-B or Blank w/Instructions on Back w/Instructions on Back
1095-C Pressure Seal B95BFPREC05 B95CFPREC05
1095-C
Item # Description Form Type
B95CFPREC05 1095-C Full Page Recipient Form
w/Instructions on Back Preprinted Laser Instructions Here
B95CHPREC05 1095-C Half Page Recipient Form
w/Instructions on Front Preprinted Laser
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 Instructions Here
w/Instructions on Back Pressure Seal
PS95CMW* Pressure Seal 14" EZ Fold 1095-C Preprinted
w/Instructions on Back Pressure Seal
81652* Pressure Seal 14" EZ Fold 1095-C Preprinted
Pressure Seal 1095-C Half Page Recipient Form Blank 1095-C Form w/Instructions
81650* Pressure Seal 14" EZ 1095-B or Blank w/Instructions on Front on Back
1095-C Pressure Seal B95CHPREC05 B95CPERFI05
*Order in increments of 500

Eccentric Z-Fold

COMPATIBLE 1095-C Preprinted Pressure Seal
ENVELOPES 14" EZ Fold
ON PAGE 16 81652
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