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SIMPLE INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT
Form 5305SA (Revised March 2002) under Section 408(p) of the Internal Revenue Code (Code)
The Participant named above is establishing a savings incentive
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How to fill out form 5305-sa simple individual
How to fill out Form 5305-SA simple individual:
01
Start by downloading the form from the official Internal Revenue Service (IRS) website. Ensure that you have the latest version of the form.
02
Fill in your personal information in Section I of the form. This includes providing your name, address, and social security number.
03
In Section II, indicate whether you are establishing a new health savings account (HSA) or contributing to an existing HSA. If you are establishing a new HSA, provide the effective date of the HSA.
04
If you are making a rollover contribution from another HSA, fill in the details of the previous HSA in Section III.
05
In Section IV, specify the type of contribution you are making - whether it is a one-time contribution or recurring contributions. If you are making recurring contributions, provide the frequency and amount of each contribution.
06
If you are designating a beneficiary for your HSA, complete Section V by providing their name and relationship to you. You can also indicate multiple beneficiaries and the percentage each should receive.
07
Section VI is for additional information. Use this section if you need to provide any additional details or explanations regarding your HSA contributions or beneficiary designation.
08
Review the completed form for accuracy and make any necessary corrections.
09
Sign and date the form in the designated areas. If applicable, so should the trustee or custodian of your HSA.
10
Keep a copy of the completed form for your records and submit it to the appropriate party as instructed by the IRS.
Who needs Form 5305-SA simple individual:
01
Individuals who want to establish or contribute to a health savings account (HSA) can use this form.
02
Employers who want to provide a simple HSA option for their employees may also need to use this form.
03
Self-employed individuals or those with a qualifying high-deductible health plan may find Form 5305-SA useful when setting up their own HSA.
It is important to note that while this information provides a general overview of how to fill out the form and who may need it, consulting with a tax professional or referring to the IRS instructions for Form 5305-SA is recommended for detailed guidance specific to your situation.
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