Federal id number on 1099-sa

Form 1099-SA. Mailed to you by January 31. Used for your tax returns to report distributions from your HSA during the previous calendar year. Note: You are not required to include …

Federal id number on 1099-sa. Click the red menu on the top left, click My Accounts, then select Benefit Account Summary. Select the Tax Forms link in the Account Resources section. This is located just above your account balance graph. You may be prompted to complete a PDF verification step. Follow the instructions provided.

The IRS has released the 2018 Form 1099-SA, Form 5498-SA and Instructions. Form 1099-SA is used to report distributions from an HSA, Archer MSA, or Medicare Advantage MSA. ... On Form 1099-SA, “PAYER’S federal identification number” and “RECIPIENT’S identification number” is now “PAYER’S TIN” and …

Post University has provided the required Internal Revenue Service Form 1098-T (Tuition Payments Statement) electronically to every student enrolled during the previous tax year to verify a student’s enrollment for at least half time and/or as a graduate. 1098T Tax Form Access from the Student Portal ». Post University cannot provide you ...HSA Tax Forms. HealthEquity provides the Health Savings Account (HSA) tax Form 1099-SA and Form 5498-SA by January 31st. Your HSA tax forms will be made available in your preferred format - mail or digital. If you opted in for digital delivery, your forms will be available in your member portal, and you will receive an email notifying you they ...Contact UMB at 1.888.486.2448 with questions about your 1099-SA or 5498-SA. Form 1099-INT, 1099-R and 1099-SA statements will be available online for immediate download on Online Banking by the end of January. Please note, some tax statements are not currently available online. All tax statements will be mailed by January 31. General and specific form instructions are provided separately. You should use the 2013 General Instructions for Certain Information Returns and the 2013 Instructions for Forms 1099-SA and 5498-SA to complete Form 1099-SA. A chart in the general instructions gives a quick guide to which form must be filed to report a particular payment. You can e-file any Form 1099 for tax year 2022 and later with the Information Returns Intake System (IRIS). The system also lets you file corrections and request automatic extensions for Forms 1099. 10 or more returns: E-filing is required. For system availability, check IRIS status. Get solutions to known issues.Federal ID Number: 00-0000000 NAME ADDRESS CITY, STATE, ZIP Customer Service:800-544-3716 Visit Us Online:Fidelity.com Envelope 0000000000 2014 Form 1099-SA Distributions from an HSA Account No. Taxpayer ID. Page 111-111111 ***-**-XXXX 1 of 2 Form 1099-SA 2014 Distributions from an HSA This information is being furnished …

Instructions for Recipient. Distributions from a health savings account (HSA), Archer medical savings account (MSA), or Medicare Advantage (MA) MSA are reported to you on Form 1099-SA. File Form 8853 or Form 8889 with your Form 1040 or 1040-SR to report a distribution from these accounts even if the distribution isn’t taxable. Mar 6, 2023 · 5498-SA: this tax form is generally available by May 31st If you opened an HSA and took distributions (including rollover distributions) during the tax year in question, you will see an IRS Form 1099-SA listed under your "Tax Forms" in the "Documents" section of your account. 1099-R and RMD notices. Mailed by Jan. 31, 2024. 1099-INT and 1099-DIV forms. Mailed by Feb. 15, 2024. 1099-SA form. Mailed by Jan. 31, 2024, for customers who receive paper tax forms and/or available on your online portal. Year-end/4th quarter statements. Mailed by Jan. 31, 2024, and/or available on your online portal. Form 5498. Mailed by May ... Feb 5, 2020 ... Your employees receive a number of tax benefits when they utilize a health savings account. ... 1099-SA, this form is for employee reference ...Federal ID Number: 00-0000000 NAME ADDRESS CITY, STATE, ZIP Customer Service:800-544-3716 Visit Us Online:Fidelity.com Envelope 0000000000 2014 Form 1099-SA Distributions from an HSA Account No. Taxpayer ID. Page 111-111111 ***-**-XXXX 1 of 2 Form 1099-SA 2014 Distributions from an HSA This information is being furnished …What is the Federal ID number on 1099 SA? The federal identification number should be located on the left side under the heading of “PAYER’S federal identification number”. If it is blank, then call the HSA plan administrator (the “Payer”) and ask them what it is. Do all EIN numbers start with 9?Form 1095-B. Form 1095-C. Form 1099-SA. Form 1095-A, Health Insurance Marketplace Statement, is used by the Marketplace to report your insurance coverage to the federal government. You use information from this form to complete Form 8962, Premium Tax Credit. Anyone in your household who has a Marketplace plan this year should receive Form 1095 ...

In today’s digital age, small businesses face numerous challenges and obstacles when it comes to operating legally and efficiently. One crucial aspect that often gets overlooked is...Jan 19, 2024 · IRS Form 1099-SA Instructions. Get the Form! If you received distributions from a health savings account or a medical savings account, you should receive a copy of IRS Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA the following tax year. In this article, we’ll walk you through what you need to know about this ... We've also prepared a number of helpful resources to assist you in filing your taxes. 1099 Forms. If your account had more than $10 in dividends or more than $20 in sales during the tax year, you received IRS Form 1099-DIV or 1099-B from Computershare. This form is required for filing your taxes.1 Best answer. FrankF1. New Member. You should receive Form 1099-SA from the trustee that holds your HSA or MSA account. Payers name and payers address is in the "TRUSTEE'S/PAYER'S name" box at the top left of Form 1099-SA. The federal ID number is in the "PAYER'S federal identification number" box under the …What is the Employer Identification Number (EIN) for BMO Harris? • For IRA tax forms 1099- Q, 1099-R, 5498, 5498 -SA, and 5498-ESA, the BMO Harris EIN is : 47-5455127. • For all other forms (including Form 1099-INT and Form 1098), the BMO Harris EIN is : 36-2085229. Author ...May 9, 2024 · So for a received 1099-MISC, a Payer's TIN is their Federal tax ID number. If the 1099-MISC was sent to you, then you are the recipient or payee. If the 1099-MISC was sent to you, then you are the recipient or payee.

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Form 1099-SA reports distributions from HSAs, MSAs, or MA MSAs. Learn who has to file, when distributions are taxable or not, and how to report them on your tax re…If you have questions about reporting on Form 1099-SA, call the information reporting customer service site toll free at 1-866-455-7438 or 304-263-8700 (not toll free). Persons with a hearing or speech disability with access to TTY/TDD equipment can call 304-579-4827 (not toll free). Title. 2014 Form 1099-SA.Instructions for Recipient. Distributions from a health savings account (HSA), Archer medical savings account (MSA), or Medicare Advantage (MA) MSA are reported to you on Form 1099-SA. File Form 8853 or Form 8889 with your Form 1040 or 1040-SR to report a distribution from these accounts even if the distribution isn’t taxable.Jan 19, 2024 · IRS Form 1099-SA Instructions. Get the Form! If you received distributions from a health savings account or a medical savings account, you should receive a copy of IRS Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA the following tax year. In this article, we’ll walk you through what you need to know about this ...

2023 Form 1099-SA Distributions from an HSA. National Financial Services LLC 123-456789 ***-**-0000 1 of 2 Agent for Fidelity Personal Trust Company P.O. Box 28019 …The 1099-MISC is a tax form for Certain Government Payments. DOR sends 1099-MISC forms for to WFTC credit recipients who indicate that they itemize their federal taxes. You may need to report your WFTC refund on your next year’s federal tax return as an offset to an itemized deduction. Contact the IRS for tax-reporting obligations.If I completed my state and federal charged on 4/23/24 and was charged, why wouldn't I receive an email saying my taxes have been accepted? elhillard New MemberA: There are 3 tax forms associated with health savings accounts (HSAs): IRS Form 1099-SA, 5498-SA and IRS Form 8889. Please use the information in your 1099-SA form, available online, to fill out IRS tax form 8889. Form 8889 is the only one you need to submit with your taxes. You can find IRS tax form 8889 in the "Statements & Docs" section ...June 7, 2019 4:21 PM. The Federal Identification number is located under the Payer's name and address on the left side of the Form 1099-R. June 7, 2019 4:21 PM. Nothing is below the address box for Payer's Name. The net thing printed is my information. June 7, 2019 4:21 PM. **Disclaimer: This post is for discussion purposes only and is NOT tax ...LMCU's Tax ID number is 38-1215360. ... 1099-SA, 1099-Q, 1099-R, 1099-INT, 1099-MISC, 1099. Available by May 31: forms 5498, 5498-SA, 5498-ESA. Please note these forms are not needed to file taxes but should match the information you filed on your returns and be kept for your records.4. The employer identification number (EIN) or the last four digits of the social security number (SSN). 5. Account Executive’s (AE) identification number. The name and number of your AE appear on your monthly statement. 6. The original and/or corrected Consolidated Form 1099 will be dated. 7. Your name and address as of December 31, 2010. 8. Visit the ‘Statements and Tax Forms’ page in your profile to access them now. File Form 1099-SA to report distributions from an HSA. File Form 5498-SA to report contributions to an HSA. File Form 8889 to report your HSA contributions and distributions. Refer to Form W-2 for your HSA contributions. Access your HealthEquity tax forms. The Internal Revenue Service (IRS) creates B Notices based on the tax identification number (TIN) or TIN owner name combination from the previous tax year 1099 Miscellaneous reporting. If Aetna’s file doesn’t match what the IRS has on file for a TIN or TIN owner name, the TIN/TIN owner name is put on the B Notice file. Ask independent contractors or employers for their individual TIN so you can complete their hiring and tax paperwork. Look on your most recent W-2 or 1099 to find your employer's EIN. Call the IRS at 800-829-4933 if you've misplaced your own business's EIN and can't locate it on any of your business records. Method 1.Before a payer can file a Form-1099, payees need to provide their Taxpayer Identification Number (TIN) on a completed W-9. This is to ensure the IRS knows ... The Internal Revenue Service (IRS) creates B Notices based on the tax identification number (TIN) or TIN owner name combination from the previous tax year 1099 Miscellaneous reporting. If Aetna’s file doesn’t match what the IRS has on file for a TIN or TIN owner name, the TIN/TIN owner name is put on the B Notice file.

A Form 1099 will have your Social Security number or taxpayer identification number on it, ... a 1099-SA is simply proof that the money left the account and went to you. ... Federal Income Tax ...

What do I need to do with Form 1099-SA? Save it. You’ll use it to complete IRS Form 8889. As an HSA account holder, you must complete Form 8889 when you file your federal tax return. You can find more information on Form 8889 at www.irs.gov. Click Search Forms &IRS Form 1099-SA reflects all distributions from your HSA for the previous tax year. You will only receive this tax form if you've taken distributions for the ...Key Features of IRS 1099-SA. • All the single taxpayers who get the distributions from Medicare Advantage, medical savings and health savings accounts will receive a form 1099-SA in their respective mail. • On any one of Form the two forms the information from Form 1099-SA is reported and the two form are Form 8853 or Form 8889.If they don't receive the missing or corrected form from their employer or payer by the end of February, they may call the IRS at 800-829-1040 for help. They'll need to provide their name, address, phone number, Social Security number and dates of employment. They'll also need to provide the employer's or payer's name, address and phone number.Federal ID Number: 00-0000000 NAME ADDRESS CITY, STATE, ZIP Customer Service:800-544-3716 Visit Us Online:Fidelity.com Envelope 0000000000 2014 Form 1099-SA Distributions from an HSA Account No. Taxpayer ID. Page 111-111111 ***-**-XXXX 1 of 2 Form 1099-SA 2014 Distributions from an HSA This information is being furnished …What is the Employer Identification Number (EIN) for BMO Harris? • For IRA tax forms 1099- Q, 1099-R, 5498, 5498 -SA, and 5498-ESA, the BMO Harris EIN is : 47-5455127. • For all other forms (including Form 1099-INT and Form 1098), the BMO Harris EIN is : 36-2085229. Author ...PAYER’S federal identification numberRECIPIENT’S identification number 2 Earnings on excess cont. $$ RECIPIENT’S name Street address (including apt. no.) City, state, and ZIP code Account number (see instructions) Form 1099-SA Cat. No. 38471D Department of the Treasury - Internal Revenue Service Form 1099-SA 3 Distribution code 4 FMV on ...

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IRS Form 1099-R. QRP and IRA distributions are reported on IRS Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc. The required distribution information must be entered as follows, depending on the type of account and the boxes that apply.Jan 4, 2024 · If you are guilty of the latter, there is no hiding from the IRS. That is because when you make a withdrawal, your HSA provider sends you a copy of IRS Form 1099-SA. Box 3 — which we cover in detail below — has a special code to identify your withdrawal. By law, your provider must send your form by January 31. How to fill out 1099 SA: 01. Obtain the correct version of Form 1099 SA from the Internal Revenue Service (IRS) website or a tax preparation software. 02. Enter the name, address, and taxpayer identification number (usually the social security number) of the person or entity that received the distribution. 03.Instructions for Forms 1099-SA and 5498-SA (2019) (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN)) on payee statements. Truncation is not allowed on any documents the filer files with the IRS.If so, the Payer is the person/institution that sent you the form. So for a received 1099-MISC, a Payer's TIN is their Federal tax ID number. If the 1099-MISC was sent to you, then you are the recipient or payee. TIN is a generic term that encompasses many types of taxpayer ID numbers. Here's more info on TINs: Step 1: Contact the Issuer. The first step is to contact the issuer of the Form 1099-SA. This is typically the financial institution that manages your HSA or MSA account. You can contact them and ask if they have sent out the form yet and if there are any issues with the mailing address they have on file for you. Look to the company that issued to Form 1099-SA. As BMcCalpin remarks above, look closely at the 1099-SA and you'll see that it says, "Trustee's/Payer's". The Payer's federal ID number is the the box labeled "PAYER'S TIN" (Tax Identification Number). See this tax tips article for more information about Form 1099-SA.HSA Tax Forms. HealthEquity provides the Health Savings Account (HSA) tax Form 1099-SA and Form 5498-SA by January 31st. Your HSA tax forms will be made available in your preferred format - mail or digital. If you opted in for digital delivery, your forms will be available in your member portal, and you will receive an email notifying you they ...When it comes to conducting a business ID number lookup, there are several methods available to individuals and organizations. One of the most efficient ways to conduct a business ...1099-G is used for tax Refunds, for Unemployment, for State Family Medical Leave, for Grants, etc. The State's FEIN won't change from year to year. "This year" will be the same as the other years.Reporting Agencies cannot use the Statewide Federal Identification Number and are responsible to create and report IRS Form 1099 under their own assigned Tax Identification Number. Reporting Agencies may use statewide vendor numbers, but these payments and vendors will automatically be excluded from statewide reporting for 1099 …Turbo Tax asked for a Federal ID number on form 1099-R. What is it? My form doesn't have this field. Thank you for the quick response!!! ‎March 11, 2023 7:14 PM. 0 171 Reply. Bookmark Icon. Still have questions? Make a post. Featured forums. Taxes. Lower Debt. Investing. Self-Employed. ….

As needed, you can take tax-free distributions from your account to pay for qualified medical expenses of the account beneficiary or the beneficiary’s spouse or dependents. You will receive a Form 1099-SA that shows the total amount of your annual distributions (i.e. money you used) reported in box 1.Fidelity Charitable's federal Tax Identification Number is: 11-0303001 and the most current Form 990 and Annual Reports are available on our About Us page. (Video) Fidelity Tax Forms. (TruFinancials)A 1099-SA is a U.S. tax form that reports distributions made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare ...1099-R: IRA distributions: January 31st: 1099-SA: HSA distributions: January 31st: 1099-Q: ... What is Landmark's Tax ID number for my tax return? Landmark's Federal Tax ID number is 39-0203995. Routing Number 275079714. About Us Careers; News; Locations; Schedule Appointment;If so, the Payer is the person/institution that sent you the form. So for a received 1099-MISC, a Payer's TIN is their Federal tax ID number. If the 1099-MISC was sent to you, then you are the recipient or payee. TIN is a generic term that encompasses many types of taxpayer ID numbers. Here's more info on TINs:In today’s digital age, the convenience and efficiency of online services have become increasingly important. This holds true for various government transactions as well, including...Form 1095-B. Form 1095-C. Form 1099-SA. Form 1095-A, Health Insurance Marketplace Statement, is used by the Marketplace to report your insurance coverage to the federal government. You use information from this form to complete Form 8962, Premium Tax Credit. Anyone in your household who has a Marketplace plan this year should receive Form 1095 ...Tax form timeline: Form 1099-SA. Mailed to you by January 31. Used for your tax returns to report distributions from your HSA during the previous calendar year. Note: You are not required to include the amounts as income unless they were used for non-qualified expenses. Form 5498-SA. Mailed in May of each year.The Tax Identification Number associated with your UMB Healthcare Services HSA will be displayed on your tax forms. What HSA tax documents will I receive from UMB? When … Federal id number on 1099-sa, Step 1: Determine your eligibility. You may apply for an EIN online if your principal business is located in the United States or U.S. Territories. The person applying online must have a valid Taxpayer Identification Number (SSN, ITIN, EIN). You are limited to one EIN per responsible party per day., Mar 6, 2023 · 5498-SA: this tax form is generally available by May 31st If you opened an HSA and took distributions (including rollover distributions) during the tax year in question, you will see an IRS Form 1099-SA listed under your "Tax Forms" in the "Documents" section of your account. , On my 1099-SA ...Tax form is asking for Federal ID number. There is not a Federal ID number but there is a Payers TIN number. Is that the same? US En . United States (English) United States (Spanish) Canada (English) Canada (French) TURBOTAX; Expert does your taxes. Back. Expert does your taxes., Tax Filing Information for HSAs. Employers will provide disclosure on the W-2 (Box 12-W) for payroll contributions pertaining to employee and employer contributions. W-2 reporting. Account holders will receive tax forms 1099-SA and 5498-SA (mailed and available online at the end of January)., 4. The employer identification number (EIN) or the last four digits of the social security number (SSN). 5. Account Executive’s (AE) identification number. The name and number of your AE appear on your monthly statement. 6. The original and/or corrected Consolidated Form 1099 will be dated. 7. Your name and address as of December 31, 2010. 8., Step 1: Determine your eligibility. You may apply for an EIN online if your principal business is located in the United States or U.S. Territories. The person applying online must have a valid Taxpayer Identification Number (SSN, ITIN, EIN). You are limited to one EIN per responsible party per day., Do not have a valid SSN/TIN number on file; International students (unless requested with SSN and/or TIN on file) Enrolled in non-degree programs; No qualified tuition and fees were charged during the calendar year; Request Your 1098-T Form. You do not need to make a formal request to receive the 1098-T form unless you are an international student., The Internal Revenue Service (IRS) creates B Notices based on the tax identification number (TIN) or TIN owner name combination from the previous tax year 1099 Miscellaneous reporting. If Aetna’s file doesn’t match what the IRS has on file for a TIN or TIN owner name, the TIN/TIN owner name is put on the B Notice file., In today’s digital era, safeguarding your online identity has become more crucial than ever. With the increasing number of cyber threats and data breaches, it is essential to take ..., May 31, 2019 · May 31, 2019 8:47 PM. The Federal ID and the Payer's ID are one in the same. Most 1099-SA forms read PAYER'S federal identification number. A valid federal employer ID number (EIN) is nine digits long. The first two digits are separated from the remaining seven digits by a dash, like 12-3456789. The dash is required, per the IRS. , February 5, 2021 6:39 AM. On the 1099-R form the Payer's Federal ID number is located in the box just below the Payer's name and address, on the left side of the form. It's referred to as a TIN (Tax ID Number) on the form. Every January, PERS mails Internal Revenue Service (IRS) Form 1099-R to each retiree who received benefits the previous ..., Form 1099-SA definition and meaning. Form 1099-SA is a federal tax form that reports distributions from Health Savings Accounts (HSAs), Archer Medical Savings Accounts (Archer MSAs), and Medicare Advantage Medical Savings Accounts (MA MSAs).The trustee managing the account submits this form to the Internal Revenue …, So if you contributed $1,500 to your HSA and your employer matched it dollar for dollar, box 12 on your W-2 would show $3,000 with a code W. To enter Form 1099-SA: Open or continue your return in TurboTax. Select Search and enter 1099-SA. Select Jump to 1099-sa. Answer the questions and continue through the screens., To enter this within the program, please go to: Federal. Deductions - Select My Forms. Adjustments to Income. Health Savings Account Form 8889 or Medical Savings Account Form 8853. Information from your 1099-SA should be entered on Form 8889 (for HSA) or Form 8853 (for MSA), You can access your Form 1099G information in your UI Online account. If you received unemployment benefits before filing a claim for DI benefits and did not receive a Form 1099G, contact the 1099G Service Line at 1-866-401-2849, Monday through Friday, from 8 a.m. to 5 p.m. (Pacific time) except on state holidays., A company identification number is a number assigned to the business upon start-up to identify this business for federal taxing and legitimacy. The number is the corporate equivale..., Form 1099-SA will list the financial institution or the insurance company that holds the account as a payer. Medicare Advantage MSA Adults must be 65 years of age or older to qualify for this plan., In today’s digital age, small businesses face numerous challenges and obstacles when it comes to operating legally and efficiently. One crucial aspect that often gets overlooked is..., Distribution in year of death. If you learn of the account holder's death and make a distribution to the beneficiary in the year of death, issue a Form 1099-SA and enter in: Box 1, the gross distribution; Box 3, code 4 (see page 2); and. Box 4, the FMV of the account on the date of death. Distribution after year of death. , Federal ID Number: 00-0000000 NAME ADDRESS CITY, STATE, ZIP Customer Service:800-544-3716 Visit Us Online:Fidelity.com Envelope 0000000000 2014 Form 1099-SA Distributions from an HSA Account No. Taxpayer ID. Page 111-111111 ***-**-XXXX 1 of 2 Form 1099-SA 2014 Distributions from an HSA This information is being furnished to the Internal Revenue ... , country, ZIP or foreign postal code, and telephone number. PAYER'S federal identification number. RECIPIENT'S identification number. RECIPIENT'S name Street address (including apt. no.) ... 1099-SA, call the information reporting customer service site toll free at 1-866-455-7438 or 304-263-8700 (not toll free). ..., Why did I receive more than one IRS 1099-SA Form or 5498-SA Form? You may receive more than one form 1099-SA in the . event you had different types of distributions during the reporting period. The 1099-SA form is limited to one type You may also receive more than one form 1099-SA or 5498-SA form in the event you are issued a corrected tax . form., If you enter a dependent who was not covered during the reporting period, they will not be included on the form. Please contact Harvard Pilgrim Member Services at (888)-333-4742 if you need additional assistance. Please enter the name (s) and date (s) of birth for dependents you wish to include on the 1099-HC form., 1099 Forms Online. Welcome to the 1099 Forms Online site. Here, you will be able to retrieve 1099-MISC, 1099-NEC, and/or 1099-INT forms associated with your Tax Identification Number (TIN). This includes any of these forms issued by UnitedHealth Group and its affiliates. For security, begin by signing in through your One HealthCare ID account., Form 1099-SA reports distributions from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA). The form does not include the federal ID number of the account holder or beneficiary, but the IRS may request it for verification purposes., Form 1099-SA is available as an online fillable PDF. If you are filing by paper, you may file a black-and-white Copy A that you print from the IRS website, along with IRS Transmittal Form 1096. [8] 3. Copy A – IRS. If filing by paper, Copy A, along with Form 1096, must be filed with the IRS by February 28. The mailing address to which you ..., 1099-SA: HSA distributions: January 31st: 1099-Q: ... Landmark's Federal Tax ID number is 39-0203995. Routing Number 275079714. About Us Careers; News; Locations;, Learn how to report distributions from a health savings account (HSA) on Form 1099-SA. Find out what information to include, how to file, and what to do in case of mistakes or closures., Form 1099-SA form is used to report total distributions made from your HSA for the tax year. It is also used to report any excess contributions you removed., Supported Federal Tax Forms. All Major Tax ... Our free federal service includes basic, premium, and self-employed tax forms. ... Form 1099-SA; Form 2439; Form 5498 ..., Learn where to locate the payer's tax identification number on your 1099-SA form, which is usually the HSA administrator or the financial institution that issued the …, SAMPLE Form 1099-SA TRUSTEE’S/PAYER’S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number OMB No. 1545-1517 20XX Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA PAYER’S federal identification number RECIPIENT’S identification number 1 Gross ..., Form 1099-SA form is used to report total distributions made from your HSA for the tax year. It is also used to report any excess contributions you removed.