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5498-SA 3up HSA, Archer MSA, or Medicare Advantage MSA Information - Trustee Copy C (9381)

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5498-SA 3up HSA, Archer MSA, or Medicare Advantage MSA Information - Trustee Copy C

(9381)
HSA, Archer MSA, or Medicare Advantage MSA Information Use Form 5498-SA Copy C to print and file copy. 5498-SA Forms are 3up on an 8 1/2 x 11" sheet with a 1/2" side perforation and are printed on 20# laser paper. Order the quantity equal to the number of participants for which you file.

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5498-SA 3up HSA, Archer MSA, or Medicare Advantage MSA Information - Trustee Copy C (9381)

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