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FORM 1094-C
Click on the individual boxes below for specific IRS Instructions
| Part II: ALE Member Information |
| Line 20, Total Number of Forms filed by and/or on behalf of the employer. |
| Line 21, ALE Member is part of Aggregated ALE Group |
| Line 22, Certifications of Eligibility |
| Part III: ALE Member Information — Monthly (Lines 23–35) |
| Column (a), Minimum Essential Coverage |
| Column (b), Full-Time Employee Count for ALE Member |
| Column (c), Total Employee Count for ALE Member |
| Column (d), Aggregated Group Indicator |
| Column (e), Aggregated Group Indicator |
| Part IV: Other ALE Members of Aggregated ALE Group |
| Lines 36-65, Other ALE Members of Aggregated ALE Group |
