Form 1099-SA - Distributions From an HSA, Archer MSA, or Medicare Advantage MSA

Distributions From an HSA, Archer MSA, or Medicare Advantage MSA

OMB: 1545-1517

IC ID: 18577

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Information Collection (IC) Details

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Form 1099-SA - Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1099-SA Distributions From an HSA, Archer MSA or Medical Advantage MSA f1099-sa--2024-11-00.pdf Yes Yes Fillable Fileable
Instruction i1099-sa_and_5498-sa--2025-00-00_draft.pdf Yes No Printable Only
Instruction i1099-general--2025-00-00.pdf Yes No Printable Only

General Government Taxation Management

Treasury/IRS 22.061–Information Return Master File (IRMF); Treasury/IRS 24.030-Customer Account Data Engine Master File; and IRS 34.037–IRS Audit Trail and Security Records System  83 FR 42980

10,500 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 20,392,600 0 0 20,366,761 0 25,839
Annual IC Time Burden (Hours) 3,738,643 0 0 3,735,025 0 3,618
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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