Attention:
This form is provided for informational purposes only. Copy A appears in red, similar to
the official IRS form. Do not file Copy A downloaded from this website. You can only file
printed versions of Copy A that comply with Publication 1179.
The HCTC Transaction Center, as an administrator of the Health Coverage Tax Credit
(HCTC), will file the required returns and furnish statements to the recipients unless you
elect to file and furnish information returns and statements on your own. Contact the
HCTC Transaction Center for this purpose by calling 1-866-628-4282.