Request for 1095-c FORM

IMPORTANT HEALTH COVERAGE TAX DOCUMENT AVAILABLE

Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) for the 2025 calendar year is available upon request.

This form provides information about the health coverage offered to you by AZ Slims Restaurants.

To request a copy of your Form 1095-C, you may:

• Email:      tony@azslims.com or anjanette@azslims.com
• Call:      480.665.7023
• Mail      a written request to:
      AZ Slims Restaurants
      Attn: Benefits Department
      650 N 99th Ave Suite 108
      Avondale, AZ 85323

Please include your full name, current mailing address, and the year requested.

A copy of your Form 1095-C will be provided within 30 days of your request.