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COBRA Recipients [Line 12b].

Reminder:

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

Use these instructions for form revisions 2024 and Later with tax quarters of 202403 and Later only.

The Schedule R is attached to:

Enter an "X" if the Form 941-X box is marked.

LN nn Col a - EIN

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▸Contents — Internal Revenue Manual Part 3. Submission Processing
Internal Revenue Manual Part 3. Submission Processing

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