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IRS 8853 2015 free printable template

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Form8853Department of the Treasury Internal Revenue Service (99)Archer MSAs and LongTerm Care Insurance ContractsOMB No. 154500742017Go to www.irs.gov/Form8853 for instructions and the latest information.
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How to fill out IRS 8853

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How to fill out IRS 8853

01
Obtain Form 8853 from the IRS website or your tax software.
02
Fill in your personal information at the top of the form, including your name and Social Security number.
03
Indicate the type of plan you are reporting (Health Savings Account (HSA) or Archer Medical Savings Account (MSA)) in the appropriate section.
04
Complete Part I by providing information related to your account or insurance coverage.
05
If you have contributions, complete Part II with details about the contributions made to the HSA or MSA.
06
If applicable, complete Part III by reporting distributions you took from the account.
07
Review your entries for accuracy, and check the instructions for any specific calculations required.
08
Sign the form and ensure it is included with your Form 1040 when filing your taxes.

Who needs IRS 8853?

01
Individuals who have a Health Savings Account (HSA) or an Archer Medical Savings Account (MSA) need to file IRS Form 8853.
02
Taxpayers who made contributions to or took distributions from these accounts during the tax year.

Instructions and Help about IRS 8853

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If you (or your spouse, if filing jointly) received distributions from a Medicare Advantage MSA in 2022, you must file Form 8853 with a Form 1040, 1040-SR, or 1040-NR even if you have no taxable income or any other reason for filing Form 1040, 1040-SR, or 1040-NR.
Use Form 8853 to: Report Archer MSA contributions (including employer contributions. Figure your Archer MSA deduction. Report distributions from Archer MSAs or Medicare Advantage MSAs.
Use Form 8853 to: Report Archer MSA contributions (including employer contributions. Figure your Archer MSA deduction. Report distributions from Archer MSAs or Medicare Advantage MSAs.
If you (or your spouse, if filing jointly) received distributions from a Medicare Advantage MSA in 2022, you must file Form 8853 with a Form 1040, 1040-SR, or 1040-NR even if you have no taxable income or any other reason for filing Form 1040, 1040-SR, or 1040-NR.
Use Form 8853 to: Report Archer MSA contributions (including employer contributions. Figure your Archer MSA deduction. Report distributions from Archer MSAs or Medicare Advantage MSAs.
If you (or your spouse, if filing jointly) received distributions from a Medicare Advantage MSA in 2022, you must file Form 8853 with a Form 1040, 1040-SR, or 1040-NR even if you have no taxable income or any other reason for filing Form 1040, 1040-SR, or 1040-NR.
You should retain the enclosed IRS Form 1099-LTC for your tax records, but, since your benefits are not taxable, you are not required to file any IRS Forms or take any other action as the result of receiving the enclosed Form 1099-LTC.
Generally, no. Tax-qualified Long-Term Care Insurance benefits come to you tax-free. Insurance companies that pay long-term care insurance benefits are required by the Internal Revenue Service (IRS) to provide claimants with a 1099 LTC.
In general, the income from a long-term care insurance policy is non-taxable, and the premiums paid to buy the insurance are tax deductible.

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IRS 8853 is a tax form used to report Health Savings Accounts (HSAs) and Archer Medical Savings Accounts (MSAs).
Individuals who have contributions to an HSA or an MSA, or who received distributions from these accounts, must file IRS 8853.
To fill out IRS 8853, you must provide information about your HSA or MSA contributions, distributions, and any qualifying medical expenses. Follow the instructions on the IRS website or seek professional tax assistance.
The purpose of IRS 8853 is to ensure proper reporting of contributions and distributions related to HSAs and MSAs for tax purposes.
On IRS 8853, you must report information such as total contributions to HSAs and MSAs, distributions made, and any related deductions or credits.
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