1095-C NOTICE TO ALL EMPLOYEES, RETIREES & COBRA
You are entitled to receive a copy of your Form 1095-C upon request. Requests must
be in writing either via email at allenk@potosir3.org or sent through the mail to Keela
Allen, Payroll Administrator, 400 North Mine Street, Potosi, MO 63664. If you have any
questions you may call Keela at (573) 436-9244.
