Quote Request Form

Please have all information ready before you begin this form. You will not be able to save or submit until all required fields are completed. * Required field are marked with an asterisk.
PLEASE SELECT THE REQUESTED QUOTE
ACA Compliance Dashboard (Tracking and Reporting)
Includes tracking of all employees (measurement, stability and administrative periods) as well as hours and eligibility in addition to populating IRS 1094C/1095C forms that can be printed and distributed by the employer.
ACA Reporting Essentials Stand Alone
Includes populating IRS 1094C/1095C forms that can be printed and distributed by the employer.

Name of Company* Total Average Number of Employees
Address
City
State Zip Code
Telephone E-mail Address
How did you hear about us?
Requested by
Payroll System *
Return Quote To * Email Address

If Multiple Company, Total Number of Employees per EIN: (Please list a breakdown of companies and the number of employees for each or email a spreadsheet to aca@sync-stream.com)

Dashboard Company 1 Total Number of Employees for Company 1
Dashboard Company 2 Total Number of Employees for Company 2
Dashboard Company 3 Total Number of Employees for Company 3
This simple addition problem is a test to make sure that an actual person is completing this form:
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