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COBRA Recipients [Line 12b].

Note:

Internal Revenue Manual Part 3. Submission Processing · 2026-10-03 edition · updated 2026-10-04 · United States

Do not transcribe century digits "20" . Enter the last two digits of the year (located in the upper left corner of the return) and 03, 06, 09, or, 12 to show 1st, 2nd, 3rd, or 4th quarter, respectively.

EIN

Employer EIN from top of page

Enter the Employer EIN from the top of the page.

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▸Contents — Internal Revenue Manual Part 3. Submission Processing

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