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Caution: DRAFT FORM This is an advance proof copy of an IRS tax form. It is subject to change and OMB approval before it is officially released. You can check the scheduled release date on our website
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How to fill out form 5498-sa page 1

01
Read the instructions on form 5498-SA page 1 carefully to understand the requirements.
02
Gather all the necessary information and documents needed to fill out the form.
03
Start by providing your personal information such as your name, address, and social security number.
04
Next, fill out the section that requires information about your HSA or Archer MSA trustee or custodian.
05
Provide the account number and the Fair Market Value (FMV) of your HSA or Archer MSA as of December 31st of the tax year.
06
If you had any contributions made by or for you, report them in the appropriate section.
07
If you had any distributions from your HSA or Archer MSA, report them in the respective section.
08
Complete any additional sections or questions that apply to your situation.
09
Double-check all the information provided and make sure it is accurate and complete.
10
Sign and date the form before submitting it to the IRS.

Who needs form 5498-sa page 1?

01
Anyone who has a Health Savings Account (HSA) or an Archer MSA needs to fill out form 5498-SA page 1.
02
This form is used to report contributions, distributions, and the Fair Market Value (FMV) of your HSA or Archer MSA.
03
It is also used by the IRS to track and ensure compliance with the tax rules related to these accounts.
04
If you have made or received any contributions or distributions from your HSA or Archer MSA during the tax year, you will need to fill out this form.
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