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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 2021 and 2022 only.

Total reported on Form 943, Lines 12d and 14f, from Form 943

Enter the amount from column (m) box 1 through 5 of Sch R and/or box 1 through 8 of Sch R Continuation Sheet for form revisions 2021 and 2022.

LN 1 Col n- Tot 12e/ 14g

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