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UNITED STATES DEPARTMENT OF AGRICULTURE Farm Service Agency Washington, DC 20250 For: State and County Offices Notice FI-3084 Processing IRS Mandated Backup Withholding for TIPP Payments Approved
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How to fill out form 1096 FSA:

01
Begin by ensuring you have all the necessary information and documents related to your FSA (Flexible Spending Account).
02
Access the official IRS website or use a trusted tax software to download form 1096 FSA.
03
Fill in the basic details, such as your name, address, social security number, and employer identification number (EIN) if applicable.
04
Provide information regarding your FSA plan, including the plan administrator's name, address, and EIN.
05
Enter the total amount of distributions made from your FSA during the tax year. This amount should match the sum of all your FSA reimbursements.
06
Calculate the total number of FSA participants, including yourself, covered by the plan during the year.
07
Double-check all the entered information for accuracy and make any necessary corrections.
08
Sign and date the form.
09
Keep a copy of the filled out form 1096 for your records.
10
Mail the completed form to the appropriate IRS address as mentioned in the instructions.

Who needs form 1096 FSA:

01
Individuals who have participated in a Flexible Spending Account (FSA) during the tax year.
02
Employers or plan administrators responsible for managing and reporting FSA distributions.
03
Taxpayers who have made FSA distributions as medical expense reimbursements and need to report and summarize these amounts to the IRS for tax purposes.
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Form 1096 FSA refers to a summary transmittal form used by payers when submitting forms 1098-FSA, 1099-FSA, 1098-FSA, and 1098-FSA to the IRS. It provides a summary of all the information returns being submitted.
Any person, business, or organization that is required to file Forms 1098-FSA, 1099-FSA, 1098-FSA, or 1098-FSA with the IRS is also required to file Form 1096 FSA to summarize those returns.
To fill out Form 1096 FSA, you need to provide information such as your name, address, TIN, total number of forms being transmitted, and a checkbox indicating the type of form being transmitted. The form can be filled out electronically or manually, depending on your preference.
The purpose of Form 1096 FSA is to summarize and transmit information returns (Forms 1098-FSA, 1099-FSA, 1098-FSA, and 1098-FSA) to the IRS. It ensures that the IRS receives a summary of the information returns and helps them process and validate the individual returns more efficiently.
Form 1096 FSA requires you to report your name, address, TIN (Taxpayer Identification Number), total number of information returns being transmitted, and the type of form being transmitted (e.g., 1098-FSA, 1099-FSA, 1098-FSA, or 1098-FSA).
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