1094-B ANNOTATED REVIEW
Reporting year / draft version / packet reference:
Line 1 filer name / evidence:
Line 2 EIN / controlled source verified:
Lines 3-4 contact / telephone / responsibility confirmed:
Lines 5-8 correspondence address / approved source:
Line 9 final accompanying return count / inventory version:
FICTIONAL CEDAR INLET
CI-01: 1 covered person.
CI-02: 3 covered people.
CI-03: 8 covered people with continuation sheet.
Total people 12; Forms 1095-B 3; line 9 count 3.
Continuation sheet remains part of CI-03, not another return.
Final packet changes / recount / membership check:
Applicable signature and authorization process / actual reviewer / date:
Approved version / unresolved fact / receiving filing team: