| Quantity Number of | Lot Price |
| 50 | $19.20 |
| 100 | $36.60 |
| 200 | $64.03 |
| 300 | $77.76 |
| 500 | $105.77 |
| 1000 | $181.25 |
| >1000 | Call us at 1-800-982-3676 or Email Us For Price |
Employers with 50+ full time employees must issue this form to their employees and submit to the IRS. Form 1094-C is the related transmittal.
Be sure to order enough to give to your employees and submit to the IRS.