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Future developments. For the latest information about developments related to published go to www.irs.gov/form5498sa. Copy C For Trustee Certain To complete Form 5498-SA use Returns and The 2017 Instructions for Forms 1099-SA and 5498-SA. This amount isn t included in box 1 2 or 3. Box 5. Shows the fair market value of your HSA Archer MSA or MA MSA at the end of 2017. Other information. The trustee of your HSA Archer MSA or MA MSA may provide other information about your account on this form. Note Don t attach Form 5498-SA to your income tax return. Instead keep it for your records. 1220. developments related to Form 5498-SA and its instructions such as legislation enacted after they were Need help If you have questions about reporting on service site toll free at 1-866-455-7438 or 304-263-8700 not toll free. VOID CORRECTED TRUSTEE S name street address city or town state or province country ZIP or foreign postal code and telephone number 1 Employee or self-employed person s Archer MSA....

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How to fill out the IRS 5498-SA online

Filling out the IRS Form 5498-SA is essential for reporting contributions to Health Savings Accounts (HSAs), Archer Medical Savings Accounts (MSAs), or Medicare Advantage MSAs. This guide provides a clear and structured approach to help users complete the form online with confidence.

Follow the steps to fill out the IRS Form 5498-SA online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Locate the trustee's name and contact information at the top of the form. Ensure the details, such as address and telephone number, are correct for the entity managing your account.
  3. Enter the participant's name and taxpayer identification number (TIN). This could include your social security number, individual taxpayer identification number, or employer identification number. Only the last four digits may be shown for privacy.
  4. Complete Box 1 by providing the total contributions made to your Archer MSA in 2021 and 2022 for the year 2021. This amount may be deductible on your tax return.
  5. In Box 2, enter the total contributions made in 2021 for your HSA or Archer MSA. This includes any qualified funding from an IRA.
  6. Fill in Box 3 with the total contributions made in 2022 for your HSA or Archer MSA related to the year 2021.
  7. For Box 4, report any rollover contributions occurring from an Archer MSA to another Archer MSA in 2021, or from HSA to HSA.
  8. In Box 5, indicate the fair market value of your account at the end of 2021.
  9. Specify the type of account in Box 6. This clarifies whether the reported information pertains to an HSA, Archer MSA, or Medicare Advantage MSA.
  10. Review all the information provided for accuracy. Once confirmed, save your changes, download, print, or share the completed form as necessary for your records.

Complete your IRS Form 5498-SA online today for straightforward reporting of your health savings contributions.

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