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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 revision 2020 only.

Qualified health plan expenses allocable to qualified family leave wages from Form 943, Line 19

Enter the amount from column (v) box 1 through 5 of Sch R and/or box 1 through 8 of Sch R Continuation Sheet for form revision 2020.

LN nn Col v- Tot 23/ 26

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