5498-SA Federal Copy A

B98MSFD05

$0.15

HSA, Archer MSA, or Medicare Advantage MSA Information Use Form 5498-SA Copy A to print and mail payment information to the IRS. 5498-SA Forms are 3up on an 8 1/2 x 11" sheet with a 1/2" side perforation and are printed with black ink on 20# laser paper. Order the quantity equal to the number of participants for which you file. Mail in a batch to the IRS.