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1545-0074 2010 Attachment Sequence No. 39 separate instructions. Social security number of MSA account holder. If both spouses have MSAs, see page 1 of the instructions Section A. Archer MSAs. If you have only a Medicare Advantage MSA, skip Section A and complete Section B. Part I Archer MSA Contributions and Deductions. See page 2 of the instructions before completing this part. If you are filing jointly and both you and your spouse have high deductible health plans with self-only cov.

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Keywords relevant to Form 8853

  • Unreimbursed
  • excludable
  • 2011
  • 13b
  • OMB
  • 13a
  • 1099-LTC
  • 14a
  • rollovers
  • 24091h
  • payees
  • reimbursements
  • policyholder
  • taxable
  • worksheet
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