- "Type of HRA Plan" is a required field.
- "Purchaser Name (First/Last)" is a required field.
- "Purchaser: (Address/City/State/Zip)" is a required field.
- "Purchaser Phone" is a required field.
- "Purchaser E-mail" is a required field.
- "Church / Organization" is a required field.
- "Church / Organization (Address/City/State/Zip)" is a required field.
- "Name of Plan Administrator: (Employer unless otherwise stated)" is a required field.
- "Church Federal ID#" is a required field.
- "State of Incorporation" is a required field.
- "Number of Employees" is a required field.
- "Effective Date:" is a required field.
- "Eligible Employee Work More than _____ hours per week" is a required field.
- "Waiting Period" is a required field.
- "Benefit Limits" is a required field.
- "Choose your Benefits" is a required field.
- "Please designate the annual limit on expenses to be reimbursed" is a required field.
- "Please designate the annual limit on expenses to be reimbursed:" is a required field.
- "Name the person who will be responsible for the proper handling of medical information protected under HIPAA law" is a required field.
- "Order Submitted by" is a required field.

2022 Clergy Tax Organizer Booklet – Express Delivery
$56.00



