IRS 8889 2012 free printable template

For Paperwork Reduction Act Notice see your tax return instructions. Cat. No. 37621P 14b 14c 17b Form 8889 2012 Page 2 Income and Additional Tax for Failure To Maintain HDHP Coverage. Form Department of the Treasury Internal Revenue Service OMB No* 1545-0074 Health Savings Accounts HSAs Information about Form 8889 and its separate instructions is available at www*irs*gov/form8889. Attach to Form 1040 or Form 1040NR* Name s shown on Form 1040 or Form 1040NR Social security number of HSA...beneficiary. If both spouses have HSAs see instructions Attachment Sequence No* 53 Before you begin Complete Form 8853 Archer MSAs and Long-Term Care Insurance Contracts if required* Part I HSA Contributions and Deduction* See the instructions before completing this part. If you are filing jointly and both you and your spouse each have separate HSAs complete a separate Part I for each spouse. Check the box to indicate your coverage under a high-deductible health plan HDHP during 2012 see...instructions. from January 1 2013 through April 15 2013 that were for 2012. Do not include employer contributions contributions through a cafeteria plan or rollovers see instructions. If you were under age 55 at the end of 2012 and on the first day of every month during 2012 you were or were considered an eligible individual with the same coverage enter 3 100 6 250 for family coverage. All others see the instructions for the amount to enter. Enter the amount you and your employer contributed to...your Archer MSAs for 2012 from Form 8853 lines 1 and 2. If you or your spouse had family coverage under an HDHP at any time during 2012 also include any amount contributed to your spouse s Archer MSAs. Subtract line 4 from line 3. If zero or less enter -0-. family coverage under an HDHP at any time during 2012 see the instructions for the amount to enter. If you were age 55 or older at the end of 2012 married and you or your spouse had family coverage under an HDHP at any time during 2012 enter...your additional contribution amount see instructions. Add lines 6 and 7. Employer contributions made to your HSAs for 2012. Qualified HSA funding distributions. Add lines 9 and 10. HSA deduction* Enter the smaller of line 2 or line 12 here and on Form 1040 line 25 or Form 1040NR line 25. Caution If line 2 is more than line 13 you may have to pay an additional tax see instructions. 14a 17a Family HSA Distributions. If you are filing jointly and both you and your spouse each have separate HSAs...complete a separate Part II for each spouse. Total distributions you received in 2012 from all HSAs see instructions. b Distributions included on line 14a that you rolled over to another HSA. Also include any excess withdrawn by the due date of your return see instructions. Unreimbursed qualified medical expenses see instructions. Self-only Taxable HSA distributions. Subtract line 15 from line 14c* If zero or less enter -0-. Also include this amount in the total on Form 1040 line 21 or Form...1040NR line 21. On the dotted line next to line 21 enter HSA and the amount. If any of the distributions included on line 16 meet any of the Exceptions to the Additional 20 Tax see instructions check here.

Instructions and Help about IRS 8889

How to edit IRS 8889

How to fill out IRS 8889

Instructions and Help about IRS 8889

How to edit IRS 8889

Editing the IRS 8889 form can be done effectively using pdfFiller. By uploading your form to the platform, you can make changes easily. Use the text editing tools to correct any errors or update your information prior to submission.

How to fill out IRS 8889

To fill out IRS 8889, follow these key steps:

1. Download the form from the IRS website or through pdfFiller.
2. Gather necessary information, including your Health Savings Account (HSA) contributions and distributions.
3. Complete each section accurately, ensuring to report all relevant figures.
4. Review your entries for completeness and accuracy before submission.

About IRS 8 previous version

What is IRS 8889?

What is the purpose of this form?

Who needs the form?

When am I exempt from filling out this form?

Components of the form

What are the penalties for not issuing the form?

What information do you need when you file the form?

Is the form accompanied by other forms?

Where do I send the form?

About IRS 8 previous version

What is IRS 8889?

IRS 8889 is the form used to report Health Savings Accounts (HSAs). It is designed for taxpayers who have received distributions or made contributions to an HSA during the tax year.

What is the purpose of this form?

The purpose of IRS 8889 is to document your HSA contributions and distributions for tax purposes. This form ensures compliance with IRS regulations regarding HSAs, allowing you to claim tax deductions for contributions and account for any distributions taken from the HSA.

Who needs the form?

Taxpayers who have contributed to or received distributions from an HSA during the tax year must file IRS 8889. This includes individuals who are eligible to contribute to an HSA as well as those who have made withdrawals for qualified medical expenses.

When am I exempt from filling out this form?

You are exempt from filling out IRS 8889 if you did not make contributions to an HSA or if you did not take any distributions from an HSA. Additionally, if you are not enrolled in a high-deductible health plan during the tax year, you do not need to file this form.

Components of the form

IRS 8889 consists of several parts: Part I details HSA contributions, Part II accounts for distributions, and Part III includes information required for reporting excess contributions and tax penalties. Each section must be completed accurately to ensure the correct reporting of your HSA activity.

What are the penalties for not issuing the form?

Failing to file IRS 8889 can result in penalties, including additional taxes on unreported HSA distributions. In particular, if distributions are not reported as required, taxpayers may face an excise tax of 20% on non-qualified distributions. It is important to file the form to avoid these consequences.

What information do you need when you file the form?

When filing IRS 8889, you will need the following information:

1. Your total HSA contributions for the year.
2. Distributions taken from the HSA.
3. Details regarding any qualified medical expenses paid from the HSA.

Is the form accompanied by other forms?

IRS 8889 may be accompanied by Form 1040 when filed, as it is used to report taxable income and tax owing. It may also necessitate additional forms if you have other related tax situations, such as excess contributions.

Where do I send the form?

Send IRS 8889, along with your tax return, to the appropriate address listed in the instructions for Form 1040. The location depends on whether you are filing electronically or by mail, as well as your resident state. Always verify the latest mailing address from IRS resources or through pdfFiller.

FAQ about IRS 8889

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What is IRS 8889?

IRS 8889 is a tax form used by individuals to report Health Savings Account (HSA) contributions, distributions, and other HSA-related information for the tax year.

Who is required to file IRS 8889?

Individuals who made contributions to an HSA or received distributions from an HSA during the tax year are required to file IRS 8889.

How to fill out IRS 8889?

To fill out IRS 8889, you need to provide information about your HSA contributions, distributions, and any qualifying expenses. Follow the form's instructions carefully, detailing your contributions, the amounts withdrawn, and any applicable tax year information.

What is the purpose of IRS 8889?

The purpose of IRS 8889 is to properly report HSA contributions and distributions to ensure compliance with tax laws and to calculate any tax deductions or penalties associated with these accounts.

What information must be reported on IRS 8889?

The information that must be reported on IRS 8889 includes total HSA contributions made during the tax year, distributions taken from the account, and details about any qualified medical expenses paid with HSA funds.