Invoice Request Form – Efile 1094/1095

Please complete the form below if you are ready to make a purchase.
Our billing department will send an invoice via email which can be paid by ACH, Credit Card or Check.

Alternatively, contact our support team and we’re glad to intake your information and assist with the process:

Monday – Friday | 9:00am – 5:00pm EST
Phone: 855-606-2227

Legal Tax Name
Please include Suite, City, State, Zip
Were you referred here by your benefits broker? If so, please let us know who.
Selected Value: 11
Please provide the exact total if you are selecting the Self Service option.