HSA, Archer MSA, or Medicare Advantage MSA Information

HSA, Archer MSA, or Medicare Advantage MSA Information

OMB: 1545-1518

IC ID: 18582

Documents and Forms
Document Name
Document Type
Form
Instruction
Instruction
Instruction
Instruction
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

HSA, Archer MSA, or Medicare Advantage MSA Information
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 5498-SA HSA, ARCHER MSA OR MEDICARE ADVANTAGE MSA INFORMATION 2025 Form 5498-SA.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

IRS 22.061–Information Return Master File (IRMF); Treasury/IRS 24.030-Customer Account   80 FR 54064

10,500 0
   
Private Sector Businesses or other for-profits
 
   99 %

  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 38,473,400 0 0 38,464,233 0 9,167
Annual IC Time Burden (Hours) 6,412,233 0 0 6,410,674 0 1,559
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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