1095-C Request Form
Notice: IMPORTANT HEALTH COVERAGE TAX DOCUMENTS
The IRS has updated the ACA instructions for Forms 1095-B and 1095-C. Due to this change, we will no longer automatically mail Form 1095-C to individuals.
However, you can request a copy of your statement to be mailed or sent via email by filling out the form below.
Email: holden@holdentemp.com
Mailing address: PO Box 1275, Tarboro, NC 27886
Phone: 252-823-5303
