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Get the free 2016 Form 1099-SA. Distributions From an HSA, Archer MSA, or Medicare Advantage MSA ...

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9494 VOID CORRECTED TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number OMB No. 1545-1517 2016 Form 1099-SA PAYER'S federal
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Form 1099-SA is used to report distributions from an HSA, Archer MSA, or Medicare Advantage MSA.
Financial institutions or anyone who makes distributions from an HSA, Archer MSA, or Medicare Advantage MSA is required to file Form 1099-SA.
Fill out the payer's information, recipient's information, distribution amount, code for the type of account, and any additional information required.
The purpose of Form 1099-SA is to report distributions from HSA, Archer MSA, or Medicare Advantage MSA accounts to the IRS.
The form must include the payer's information, recipient's information, distribution amount, account type code, and any additional required information.
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