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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.
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Minimum qty of 25. Order in increments of 25.