Tax1099SA_V100

OFX / Types / Tax1099SA_V100

Form 1099-SA - Distributions From an HSA, Archer MSA, or Medicare Advantage MSA

#TagDescriptionType
1 SRVRTID ServerIdType
2 TAXYEAR YearType
3 VOID BooleanType
4 CORRECTED BooleanType
5 PAYERADDR PayerAddressType
6 RECIPADDR RecipientAddressType
7 PAYERID PAYER'S federal identification number GenericNameType
8 RECID RECIPIENT'S identification number IdType
9 ACCTNUM Account number GenericNameType
10 GROSSDIST Box 1. Gross distribution AmountType
11 EARNINGS Box 2. Earnings on excess cont. AmountType
12 DISTCODE Box 3. Distribution code GenericNameType
13 FMVON Box 4. FMV on date of death AmountType
14 HSA Box 5a. HSA BooleanType
15 ARCHER Box 5b. Archer MSA BooleanType
16 MSA Box 5c. MA MSA BooleanType
Usages:
  1. Tax1099Response TAX1099SA_V100
https://storage.googleapis.com/taxdochub-forms-png-trimmed/2025/Tax1099Sa.recipient.png

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