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Health Savings Account (HSA) Contribution Instructions 1 HSA OWNER INFORMATION NAME, ADDRESS, CITY, STATE, AND ZIP HSA ACCOUNT (PLAN) NUMBER SOCIAL SECURITY NUMBER l Slowly TYPE OF HEALTH INSURANCE

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Step 1: Start by gathering all the required documents and information. This may include your Social Security number, employment information, income details, and any relevant deductions or credits.

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Step 4: Proceed to the income section and report all sources of income you received during the tax year. This may include wages, self-employment income, interest, dividends, or retirement distributions.

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Step 7: Attach any supporting documentation, such as W-2 forms or schedules, as required.

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L self-only refers to a tax filing status where an individual files their tax return without claiming any dependents.

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Individuals who do not have any dependents or qualifying individuals to claim on their tax return are required to file l self-only.

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