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Form 4423
Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans
OMB: 1545-2251
IC ID: 214083
OMB.report
TREAS/IRS
OMB 1545-2251
ICR 202404-1545-018
IC 214083
( )
Documents and Forms
Document Name
Document Type
Form 4423
Form 4423
Form and Instruction
4423 Application for Filing Affordable Care Act (ACA) Information Returns
f4423--2016-03-00.pdf
www.IRS.gov
Form and Instruction
Information Collection (IC) Details
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