CSH - ACA Form 1095-C Preparation Services Question Title * 1. First and last name: Question Title * 2. Company name: Question Title * 3. Company mailing address (number, street, city, state, zipcode) Question Title * 4. First and last name of contact to receive fee estimate: Question Title * 5. Contact phone number: Question Title * 6. Contact email address: Question Title * 7. Do you have a primary contact at Clark Schaefer Hackett? If so, please list the name here: Question Title * 8. Does Clark Schaefer Hackett handle your company's payroll? Yes No Next