5498-SA 3up Fed. Copy A (B98MSFD05)

HSA, ARCHER MSA, or Medicare Advantage MSA Information: Use this form to print and mail payment information to the IRS. Forms are 3up format on 8 1/2" x 11" sheet with a 1/2" side perforation and printed with red scannable ink on 20# laser paper. Mail in a batch to the IRS.

Details:

Order quantity equal to number of participants you are filing.