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Form 4423 (Rev. 3-2016)

ICR 201701-1545-021 · OMB 1545-2251 · Object 71087201.

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Document Metadata
File Typeapplication/octet-stream
File TitleForm 4423 (Rev. 3-2016)
SubjectApplication for Filing Affordable Care Act (ACA) Information Returns
AuthorSE:WI:CAS:EPSS:OS
File Modified2016-04-12
File Created2016-04-12
Conversion Statefailed_conversion