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  • Hsa Distribution Request Form

Get Hsa Distribution Request Form

- - - *Day Telephone *Mailing Address *City *State *Zip Code Updates or changes to your profile can be made by logging into your account at www.discoverybenefits.com Step 2: Distribution Information *Requested Amount: Select one of the following: Normal Disability Prohibited Transaction Excess Contribution Removal Transfer Transfer Check Payable to: Mail Check to: Death (a copy of the death certificate is required) Is the distribution taken in the year of death (if you circle yes, ski.

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Related content

About Form 1099-SA, Distributions From an HSA...
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HSA DISTRIBUTION REQUEST FORM
Use this form to request a distribution from your HSA for one of the reasons indicated...
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Is there a difference? Yes, the form 1099-SA is the Distributions From an HSA Form. The 1095-C is the Employer-Provided Health Insurance Offer and Coverage and 1095-B is the Health Coverage form. You would receive a 1099-SA if you took money out of your HSA.

Amounts shown on Form 1099-SA must be reported on the taxpayer's federal income tax form.

HSA distributions and taxes Although a qualified HSA distribution is not taxable, you still must file IRS Form 8889 to report any distributions made during the year.

HSA distributions The IRS requires you to prepare Form 8889 and attach it to your tax return when you take a distribution from an HSA. However, if your 1099-SA indicates you did not use the distribution for qualified medical expenses, you will pay income tax on the portion you used for nonqualified expenses.

File Form 8889 to: Report health savings account (HSA) contributions (including those made on your behalf and employer contributions). Figure your HSA deduction. Report distributions from HSAs.

Health Savings Account (HSA) You will receive the IRS Form 1099-SA and IRS Form 5498-SA either by mail or electronically (based upon your elected delivery preference). These IRS tax forms are also available in the Member Website. IRS Form 1099-SA is provided for each HSA distribution you made in the current tax year.

To request a distribution from your HSA in your online account, complete the following steps: Log in to your online account. Navigate to the Home tab and click the applicable option in the I Want To section. ... Complete the required fields and then click "Next." Select the frequency and then click "Next."

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232