1099-SA 3up Copy A Payer/State (9378)

Distributions from an HSA, ARCHER MSA, Medicare MSA: Use this form to print and mail payment information to the recipient to file with their federal tax return. This form is a 3up format on 8 1/2" x 11" sheet with a 1/2" side perforation and are printed on 20# laser paper.

Details:

Order the quantity equal to the number recipients you are filing.

Compatible Envelopes: 99DWENV05, 99DWENVS05 (self seal)