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5498-SA Participant Copy B

9380

HSA, Archer MSA, or Medicare Advantage MSA Information Use Form 5498-SA Copy B to print and mail payment information to the participant. 5498-SA Forms are 3up on an 8 1/2 x 11" sheet with a 1/2" side perforation and are printed on 20# laser paper. Order the quantity equal to the number of participants for which you file. Mail to participants in compatible window envelopes.
99DWENV05 - Moisture Seal Double Window
99DWENVS05 - Self Seal Double Window
99SWENV05 - Moisture Seal Single Window

Minimum qty of 25. Order in increments of 25.