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HSA Return of Excess Contribution Request Use this form if you have made an excess contribution to your Fidelity Health Savings Account (HSA). You may be required to file IRS Form 5329 to report any
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You may be asked to complete and send a letter regarding the corrections to the IRS. The letter contains instructions for reporting this correction, including the due date for the return. Please keep copies of and send the letters to the following addresses: Fidelity Health Saver Services Attn: Accounts Control Branch 4140 E. Liberty Ln. #250 Kansas City, Missouri 64108 P.O. Box 912, Independence, MO 65617 This Fidelity Health Savings Account Program (HHS) helps families avoid unexpected health care costs without incurring financial hardships. This is a tax-deferred program which is administered by The Fidelity Health Care Trust (FHC TH), a wholly owned subsidiary of Cancer, Inc., a private investment company. To find out more and to read more about the Fidelity Health Savings Account, please visit. Alfred J. McDonough Investment Advisors, LLC P.O. Box 1333 Arlington, VA 22203 The “Shareholder and Director Notice: Fidelity Health Savings Account Program” is to notify the Company of such purchases of Shares of the Company.

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The HSA return of excess is a form that allows individuals who have contributed more than the maximum allowable amount to their Health Savings Account (HSA) to correct and withdraw the excess amount.
Anyone who has contributed more than the maximum allowable amount to their HSA is required to file the HSA return of excess to correct and withdraw the excess funds.
To fill out the HSA return of excess, individuals need to obtain the appropriate form from the IRS website or consult with a tax professional. The form requires providing information about the excess contributions made and calculating the earnings on the excess amount.
The purpose of the HSA return of excess is to correct and withdraw any contributions made to an HSA that exceed the maximum allowable amount. This ensures compliance with IRS regulations and avoids potential tax penalties.
The HSA return of excess requires reporting the excess contributions made to the HSA, calculating the earnings on the excess amount, and determining the taxable portion to be withdrawn.
The deadline to file the HSA return of excess in 2023 is typically April 15th, but it is recommended to consult with the latest IRS guidance or a tax professional for any specific deadline changes or extensions.
The penalty for late filing of the HSA return of excess may vary depending on the specific circumstances. It is advisable to consult with the IRS or a tax professional for accurate penalty information in case of late filing.
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