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Office Forms, Recordkeeping & Reference Materials Forms & Recordkeeping Systems Account & Recordkeeping Books Tops TOPL1094B

Tops 1094-B Transmittal for 1095-B Laser Form, 8 1/2 x 11, 25 Sheets/Pack

Item # TOP L1094B by Tops (Mfg. Part # TOPL1094B, UPC # 87958510904)


Transmittal for 1095-B. Laser printer compatible. Printed in black ink.


  • Form Size : 8 1/2 x 11

  • Forms Per Page : 1

  • Form Quantity : 25

  • Sheet Size : 8 1/2 x 11

  • Principal Heading : Transmittal of Health Coverage Information Returns

  • Layout : One Form per Sheet

  • Numbering : Preprinted at Top

  • Paper Color : White

  • Print and Ruling Color : Black

  • Numbering Color : Black

TOPL1094B - TOPS™ 1094-B Transmittal for 1095-B Laser Form
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Retail Price: $5.98
BettyMills Discount Price: $4.43 Per Pack
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Order 3+ and Save an Extra $0.09 Per Pack
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