Get the free HSA Distribution Form

Use this form for distributions from your HSA in cases when you want a check from us (or a transfer to a spouse) rather than using your debit card, checking or ACH access. This includes normal distributions,

How to fill out hsa distribution form

How to fill out HSA Distribution Form

1. Obtain the HSA Distribution Form from your HSA provider's website or office.
2. Fill out personal information including your name, address, and HSA account number.
3. Specify the type of distribution you're requesting (e.g., qualified medical expenses, reimbursements, etc.).
4. Provide the detailed information for the expenses being claimed, including amounts and dates.
5. Sign and date the form to certify the information is truthful and accurate.
6. Submit the completed form to your HSA provider as per their submission guidelines.

Who needs HSA Distribution Form?

1. Individuals who have incurred qualified medical expenses and wish to withdraw funds from their Health Savings Account (HSA).
2. HSA account holders seeking reimbursement for out-of-pocket medical costs.
3. Anyone needing to withdraw funds from their HSA for non-medical expenses, though penalties may apply.

People Also Ask about

Do I need to enter 5498-SA in TurboTax?

You don't need to enter information from your Form 5498 (IRA Contribution Information) into TurboTax like you do with a W-2 or 1099s. In most cases, you'll find the info needed for your return on other paperwork, such as a year-end summary statement or a Form 1099-R.

Do I need to enter information from form 5498 on my tax return?

No. You aren't required to do anything with Form 5498 because it's for informational purposes only.

Where can I get an HSA form?

How do I find my HSA tax forms? Log in to your account and select Manage My Reimbursement Account. Click the red menu on the top left, click My Accounts, then select Benefit Account Summary. Select the Tax Forms link in the Account Resources section. You may be prompted to complete a PDF verification step.

How do I document an HSA withdrawal?

You must report distributions from your HSA on IRS Form 8889. You will receive a separate 1099-SA for each type of distribution made during the tax year. The five distribution types are 1) normal; 2) excess contribution removal; 3) death; 4) disability; and 5) prohibited transaction.

Do I need a 5498-SA to file my taxes?

You won't get a 5498-SA form if you didn't have contributions and your balance was zero dollars at the end of the year. Please note this form is informational only and doesn't need to be filed with your income tax return. If I don't have a 5498-SA, how can I get my contributions by tax year?

Do I have to report 5498-SA on my tax return?

The trustee of your HSA, Archer MSA, or MA MSA may provide other information about your account on this form. Note: Don't attach Form 5498-SA to your income tax return. Instead, keep it for your records.

What's the difference between a 1099-SA and 5498-SA?

Form 1099-SA tells you the total distributions or payments that were made from your HSA. Form 5498-SA summarizes the contributions or deposits you made to your HSA in a particular tax year. You can also find your contribution information on your December HSA statement.

What form do you get for HSA distributions?

File Form 1099-SA to report distributions made from a: Health savings account (HSA).

For pdfFiller’s FAQs

What is HSA Distribution Form?

The HSA Distribution Form is a document used to report distributions from a Health Savings Account (HSA). It provides details about the amounts distributed and the purpose of the distributions.

Who is required to file HSA Distribution Form?

Individuals who have made distributions from their Health Savings Account are required to file the HSA Distribution Form for tax reporting purposes.

How to fill out HSA Distribution Form?

To fill out the HSA Distribution Form, you need to provide personal information, the amount of the distribution, and any information regarding qualified medical expenses related to the distribution.

What is the purpose of HSA Distribution Form?

The purpose of the HSA Distribution Form is to ensure accurate tax reporting of distributions made from an HSA, including any tax implications for the account holder.

What information must be reported on HSA Distribution Form?

The information that must be reported includes the amount of the distribution, the date of the distribution, the purpose of the distribution, and the taxpayer's personal identification details.