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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

Line 12c is only valid on form revisions 2010 (Rev. April 2010) and 2010 (Rev. Oct 2010) with a tax quarter of 201006. If the form meets this criteria and Line 12c does not display, press and enter 1110.

Number of qualified employees paid exempt wages/tips March 19-31

Enter the number of qualified employees from box 12c.

If the number is not numeric, input as numeric (e.g., two would be 2).

If the number is larger than seven numerics, enter all 9s.

If the number is dollar and cents (e.g., 123.00), enter the figure to the left of the period.

If the number is followed by a comma, in the wrong position, leave blank (e.g., 1,2,3 would be left blank but 1,000 would be input as 1000).

Exempt Wages/Qual Emp [Line 12d]

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