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Use the HSA Deceased Distribution Form for asset distribution from a deceased’s Health Savings Account to the eligible claimant. Comply with required documentation.
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The HSA deceased distribution form is a document used to report the distribution of funds from a Health Savings Account (HSA) of a deceased individual to their beneficiaries.
The executor of the deceased's estate or the designated beneficiary of the HSA is required to file the HSA deceased distribution form.
To fill out the HSA deceased distribution form, you must provide the deceased's personal information, the HSA account details, the beneficiary's information, and the distribution amount being reported.
The purpose of the HSA deceased distribution form is to inform the IRS about the distribution of HSA funds after the account holder's death and to ensure proper tax treatment of the distributed funds.
The form must report the deceased's name, Social Security number, the beneficiary's name, Social Security number, the total distribution amount, and any applicable tax information.
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