Long Term Care and Accelerated Death Benefits. This 4-part carbonless form includes Payer Copy A (federal, red scannable), and two Copy C (file/state) and Recipient Copy B. Your typewriter or pin-fed printer will print all copies at the same time. Forms are 8” wide. Mail payer copies in a batch to the IRS. Mail recipient copies in envelope #99DWENV05 or #99SWENV05 .