IRIS CSV File Format for 1099-SA

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CSV Template

Form Type,Tax Year,Trustee TIN Type,Trustee Taxpayer ID Number,Trustee Name Type,Trustee Business or Entity Name Line 1,Trustee Business or Entity Name Line 2,Trustee First Name,Trustee Middle Name,Trustee Last Name (Surname),Trustee Suffix,Trustee Country,Trustee Address Line 1,Trustee Address Line 2,Trustee City/Town,Trustee State/Province/Territory,Trustee ZIP/Postal Code,Trustee Phone Type,Trustee Phone,Trustee Email Address,Recipient TIN Type,Recipient Taxpayer ID Number,Recipient Name Type,Recipient Business or Entity Name Line 1,Recipient Business or Entity Name Line 2,Recipient First Name,Recipient Middle Name,Recipient Last Name (Surname),Recipient Suffix,Recipient Country,Recipient Address Line 1,Recipient Address Line 2,Recipient City/Town,Recipient State/Province/Territory,Recipient ZIP/Postal Code,Office Code,Form Account Number,Box 1 - Gross distribution,Box 2 - Earnings on Excess Contributions,Box 3 - Distribution code,Box 4 - Fair Market Value (FMV) on date of death,Box 5 - Indicate if this distribution was from an HSA or Archer MSA or MA MSA.
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CSV Columns

Form Type
Tax Year
Trustee TIN Type
Trustee Taxpayer ID Number
Trustee Name Type
Trustee Business or Entity Name Line 1
Trustee Business or Entity Name Line 2
Trustee First Name
Trustee Middle Name
Trustee Last Name (Surname)
Trustee Suffix
Trustee Country
Trustee Address Line 1
Trustee Address Line 2
Trustee City/Town
Trustee State/Province/Territory
Trustee ZIP/Postal Code
Trustee Phone Type
Trustee Phone
Trustee Email Address
Recipient TIN Type
Recipient Taxpayer ID Number
Recipient Name Type
Recipient Business or Entity Name Line 1
Recipient Business or Entity Name Line 2
Recipient First Name
Recipient Middle Name
Recipient Last Name (Surname)
Recipient Suffix
Recipient Country
Recipient Address Line 1
Recipient Address Line 2
Recipient City/Town
Recipient State/Province/Territory
Recipient ZIP/Postal Code
Office Code
Form Account Number
Box 1 - Gross distribution
Box 2 - Earnings on Excess Contributions
Box 3 - Distribution code
Box 4 - Fair Market Value (FMV) on date of death
Box 5 - Indicate if this distribution was from an HSA or Archer MSA or MA MSA.

CSV Guidelines

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