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  • ACA Form PS1095BCBLK Pressure Seal Blank (recipient copy), Blank Portrait 14" Pressure Seal EZ Fold. Item # PS1095BCBLK.

ACA FORM PS1095BCBLK, Pressure Seal Blank, 500/PKG.

ACA Form PS1095BCBLK Pressure Seal Blank (recipient copy) is used to report the months employees and family members were covered under the health plan.  This recipient / employee copy is a Blank Portrait 14" Pressure Seal EZ Fold.  Can be used for 1095-B and/or 1095-C, with instructions on the back.  500 per package.  FREE Shipping.

* Buy 5 or more and get 10% Discount *


SKU:
PS1095BCBLK
Price:
$119.95
Availability:
Ships UPS Ground 2-3 days.
Shipping:
Free Shipping
Quantity:
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