Tax5498SA_V100

OFX / Types / Tax5498SA_V100

Form 5498-SA - HSA, Archer MSA, or Medicare Advantage MSA Information

#TagDescriptionType
1 SRVRTID ServerIdType
2 TAXYEAR YearType
3 VOID BooleanType
4 CORRECTED BooleanType
5 TRUSTEEADDR TrusteeAddressType
6 PARTICIPANTADDR ParticipantAddressType
7 TRUSTEEID TRUSTEE’S federal identification number GenericNameType
8 PARTICIPANTID PARTICIPANT'S social security number IdType
9 ACCTNUM Account number GenericNameType
10 MSACONTRIB Box 1. Employee or self-employed person’s Archer MSA contributions made in 2017 and 2018 for 2017 AmountType
11 TOTALCONTRIB Box 2. Total contributions made in 2017 AmountType
12 TOTALMADE Box 3. Total HSA or Archer MSA contributions made in 2018 for 2017 AmountType
13 ROLLOVER Box 4. Rollover contributions AmountType
14 FMV Box 5. Fair market value OF HAS, Archer MSA, or MA MSA AmountType
15 HSA Box 6a. HSA BooleanType
16 ARCHER Box 6b. Archer MSA BooleanType
17 MAMSA Box 6c. MA MSA BooleanType
Usages:
  1. Tax5498Response TAX5498SA_V100
https://storage.googleapis.com/taxdochub-forms-png-trimmed/2025/Tax5498Sa.recipient.png

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