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1099SA Tax Form Distributions From an HSA, Archer MSA, or Medicare Advantage MSA Tax Year: 2013 CORRECTED Copy B for Recipient (keep for your records only) Trustee/Payer Information Name: ABC Bank
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How to fill out 1099-sa tax form

How to fill out 1099-SA tax form:
01
Obtain the form: The 1099-SA tax form can be obtained from the Internal Revenue Service (IRS) website or other reputable sources.
02
Gather necessary information: Before filling out the form, gather all the required information such as the payer's name, address, and taxpayer identification number (TIN), as well as the recipient's name, address, and TIN.
03
Complete payer information: Start by filling out the payer's information, including their name, address, and TIN. This information can usually be found on the form received from the payer.
04
Enter recipient information: Next, enter the recipient's information including their name, address, and TIN. Ensure that the information provided is accurate and up-to-date.
05
Report distributions: The 1099-SA form is used to report distributions made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage (MA) MSA. Enter the total distributions made during the tax year in the appropriate box on the form.
06
Indicate type of account: Check the appropriate box to indicate whether the form is reporting distributions from an HSA, Archer MSA, or MA MSA.
07
Reporting dates: Provide the date on which the distributions were made. This is usually found on the form received from the payer.
08
Taxable amount: If any portion of the distributions made is taxable, enter the taxable amount in the designated box on the form. Consult the instructions or a tax professional if you are unsure about the taxable amount.
09
Sign and submit: Once you have completed all the required fields, sign and date the form. If you are filing electronically, follow the instructions for electronic submission. If you are filing a paper form, make a copy for your records and mail it to the IRS.
Who needs 1099-SA tax form:
01
Individuals with Health Savings Accounts (HSA): Any individual who had distributions made from their HSA during the tax year may need to report these distributions using the 1099-SA tax form.
02
Individuals with Archer Medical Savings Accounts (Archer MSA): If you had distributions made from your Archer MSA during the tax year, you may need to report these distributions using the 1099-SA tax form.
03
Individuals with Medicare Advantage (MA) MSA: Individuals who received distributions from their Medicare Advantage MSA during the tax year may also need to report these distributions using the 1099-SA tax form.
It's important to note that not all individuals will receive a 1099-SA form. You should receive this form from the payer if you had distributions made from any of the aforementioned accounts. Make sure to consult the IRS guidelines or a tax professional to determine your specific filing requirements.
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