IRS 1095-C form

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2024-2025 IRS 1095-C
2024-2025 IRS 1095-C
6001201095CForm Department of the Treasury Internal Revenue Serviceman Do not attach to your tax return. Keep for your records. Go to www.irs.gov/Form1095C for instructions and the latest information.
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2023 IRS 1095-C
2023 IRS 1095-C
6001201095CForm Department of the Treasury Internal Revenue Serviceman Do not attach to your tax return. Keep for your records. Go to www.irs.gov/Form1095C for instructions and the latest information. Employee3 Street address (including apartment...
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2022 IRS 1095-C
2022 IRS 1095-C
6001201095CForm Department of the Treasury Internal Revenue Serviceman Do not attach to your tax return. Keep for your records. Go to www.irs.gov/Form1095C for instructions and the latest information. Employee3 Street address (including apartment...
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2021 IRS 1095-C
2021 IRS 1095-C
6001201095CForm Department of the Treasury Internal Revenue Serviceman I Go Do not attach to your tax return. Keep for your records. To www.irs.gov/Form1095C for instructions and the latest information. Employee3 Street address (including...
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2020 IRS 1095-C
2020 IRS 1095-C
6001201095CForm Department of the Treasury Internal Revenue Serviceman I Go Do not attach to your tax return. Keep for your records. To www.irs.gov/Form1095C for instructions and the latest information. Employee3 Street address (including...
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2019 IRS 1095-C
2019 IRS 1095-C
6001181095CForm Department of the Treasury Internal Revenue Serviceman I Go Do not attach to your tax return. Keep for your records. To www.irs.gov/Form1095C for instructions and the latest information.2 Social security number (SSN)3 Street...
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2018 IRS 1095-C
2018 IRS 1095-C
6001181095CForm Department of the Treasury Internal Revenue Serviceman I Go Do not attach to your tax return. Keep for your records. To www.irs.gov/Form1095C for instructions and the latest information. Employee3 Street address (including...
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2017 IRS 1095-C
2017 IRS 1095-C
6001171095CForm Department of the Treasury Internal Revenue Serviceman I Go Do not attach to your tax return. Keep for your records. To www.irs.gov/Form1095C for instructions and the latest information. Employee 2 Social security number (SSN)3...
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2016 IRS 1095-C
2016 IRS 1095-C
600117 1095-C Form Department of the Treasury Internal Revenue Service Part I ? Information ? Do not attach to your tax return. Keep for your records. About Form 1095-C and its separate instructions is at www.irs.gov/form1095c Employee 2 Social...
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2015 IRS 1095-C
2015 IRS 1095-C
1095CForm Department of the Treasury Internal Revenue Serviceman I InformationApplicable Large Employer Member (Employer)1 Name of employee2 Social security number (SSN)3 Street address (including apartment no.) 5 State or province4 City or toward...
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2014 IRS 1095-C
2014 IRS 1095-C
Employer-Provided Health Insurance Offer and Coverage. Information about Form 1095-C and its separate instructions is at www.irs.gov/f1095c. OMB No.
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