Tax Documents
Tax1099Sa
FDX / Data Structures / Tax1099Sa
Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
Extends and inherits all fields from Tax
Tax1099Sa Properties
| # | Id | Type | Description |
|---|---|---|---|
| 1 | payerNameAddress | NameAddressPhone | Payer's name, address, and phone |
| 2 | payerTin | string | PAYER'S TIN |
| 3 | recipientTin | string | RECIPIENT'S TIN |
| 4 | recipientNameAddress | NameAddress | Recipient's name and address |
| 5 | accountNumber | string | Account number |
| 6 | grossDistribution | number (double) | Box 1, Gross distribution |
| 7 | earnings | number (double) | Box 2, Earnings on excess contributions |
| 8 | distributionCode | string | Box 3, Distribution code |
| 9 | fairMarketValue | number (double) | Box 4, FMV on date of death |
| 10 | hsa | boolean | Box 5a, HSA |
| 11 | archerAccount | boolean | Box 5b, Archer MSA |
| 12 | medicalSavingsAccount | boolean | Box 5c, Medicare Advantage (MA) MSA |
Tax1099Sa Usage:
- TaxData tax1099Sa
FDX Data Structure as JSON
{
"tax1099Sa" : {
"taxYear" : 0,
"corrected" : true,
"accountId" : "",
"taxFormId" : "",
"taxFormDate" : "2020-07-01",
"description" : "string",
"additionalInformation" : "string",
"taxFormType" : "BusinessIncomeStatement",
"attributes" : [ {
"name" : "string",
"value" : "string",
"boxNumber" : "string",
"code" : "string"
} ],
"error" : {
"code" : "string",
"message" : "string"
},
"payerNameAddress" : {
"line1" : "String64",
"line2" : "String64",
"line3" : "String64",
"city" : "String64",
"state" : "String64",
"postalCode" : "string",
"country" : "AD",
"name1" : "String64",
"name2" : "String64",
"phone" : {
"type" : "HOME",
"country" : "string",
"number" : "string",
"extension" : "string"
}
},
"payerTin" : "string",
"recipientTin" : "string",
"recipientNameAddress" : {
"line1" : "String64",
"line2" : "String64",
"line3" : "String64",
"city" : "String64",
"state" : "String64",
"postalCode" : "string",
"country" : "AD",
"name1" : "String64",
"name2" : "String64"
},
"accountNumber" : "string",
"grossDistribution" : 0.0,
"earnings" : 0.0,
"distributionCode" : "string",
"fairMarketValue" : 0.0,
"hsa" : true,
"archerAccount" : true,
"medicalSavingsAccount" : true
}
}
Example Form PDF
Example Form JSON
{
"tax1099Sa" : {
"taxYear" : 2022,
"taxFormDate" : "2021-03-30",
"taxFormType" : "Tax1099Sa",
"payerNameAddress" : {
"line1" : "12021 Sunset Valley Dr",
"line2" : "Suite 230",
"city" : "Preston",
"state" : "VA",
"postalCode" : "20191",
"country" : "US",
"name1" : "Tax Form Issuer, Inc",
"phone" : {
"number" : "8885551212"
}
},
"payerTin" : "12-3456789",
"recipientTin" : "xxx-xx-1234",
"recipientNameAddress" : {
"line1" : "1 Main St",
"city" : "Melrose",
"state" : "NY",
"postalCode" : "12121",
"country" : "US",
"name1" : "Kris Q Public"
},
"accountNumber" : "111-23456",
"grossDistribution" : 1000.0,
"earnings" : 200.0,
"distributionCode" : "A",
"fairMarketValue" : 400.0,
"hsa" : true
}
}
Example Form JSON for QR Code Purposes
Example Form PDF with QR Code
Example Data As Flattened Map (Key, Value Pairs)
{
"taxYear": "2022",
"taxFormDate": "2021-03-30",
"taxFormType": "Tax1099Sa",
"payerNameAddress.line1": "12021 Sunset Valley Dr",
"payerNameAddress.line2": "Suite 230",
"payerNameAddress.city": "Preston",
"payerNameAddress.state": "VA",
"payerNameAddress.postalCode": "20191",
"payerNameAddress.country": "US",
"payerNameAddress.name1": "Tax Form Issuer, Inc",
"payerNameAddress.phone.number": "8885551212",
"payerTin": "12-3456789",
"recipientTin": "xxx-xx-1234",
"recipientNameAddress.line1": "1 Main St",
"recipientNameAddress.city": "Melrose",
"recipientNameAddress.state": "NY",
"recipientNameAddress.postalCode": "12121",
"recipientNameAddress.country": "US",
"recipientNameAddress.name1": "Kris Q Public",
"accountNumber": "111-23456",
"grossDistribution": "1000.0",
"earnings": "200.0",
"distributionCode": "A",
"fairMarketValue": "400.0",
"hsa": "true"
}
Issuer Instructions
