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.
Number of individuals provided COBRA premium assistance from Form 943, Line 12f
Enter the number of individuals from column (o) 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 nn Col m- Tax Adj (form revisions 2023 and Later)
LN nn Col p- Tax Adj (form revisions 2021 and 2022)
LN nn Col n-Tax Adj (form revision 2020)
LN nn Col h -Tax Adj (form revision 2017)
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