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Get 2014 Form 1094-C. Transmittal Of Employer-Provided Health Insurance Offer And Coverage Information

DRAFT AS OF October 15 2014 DO NOT FILE 1094-C Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns Form Department of the Treasury Internal Revenue Service Part I Information 120115 OMB No. 1545-2251 CORRECTED about Form 1094-C and its separate instructions is at www.irs.gov/f1094c. Applicable Large Employer Member ALE Member 2 Employer identification number EIN 1 Name of ALE Member Employer 3 Street address .

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