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Get IRS 1094-B 2014

Form 1094-B Department of the Treasury Internal Revenue Service Transmittal of Health Coverage Information Returns Information OMB No. 1545-2252 about Form 1094-B and its separate instructions is at www.irs.gov/form1094b. For Privacy Act and Paperwork Reduction Act Notice see separate instructions. Signature Title Cat. No. 61570P Date 1094-B 2014. 1 Filer s name 2 Employer identification number EIN 3 Name of person to contact 4 Contact telephone number 5 Street address including room or suite no.

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