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The trustee of your MA MSA is not required to but may show 2015. Box 4. Shows any rollover contribution from an Archer MSA to this Archer MSA in 2015 or any rollover from an HSA or Archer MSA to this HSA. VOID CORRECTED TRUSTEE S name street address city or town state or province country ZIP or foreign postal code and telephone number 1 Employee or self-employed person s Archer MSA contributions made in 2015 and 2016 for 2015 OMB No. 1545-1518 2 Total contributions made in 2015 Form 5498-SA...

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What is this information is submitted?

This information is a report of financial information.

Who is required to file this information is submitted?

All individuals or entities subject to financial reporting requirements.

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What is the purpose of this information is submitted?

The purpose is to provide transparency and accountability in financial reporting.

What information must be reported on this information is submitted?

All relevant financial data such as income, expenses, assets, and liabilities.

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