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2016 Continuous 5498-SA, 4-part, Carbonless

Item#: Size:
Quantity 25 50 100 150 200
TF6099-4  4-Parts/Quadruplicate $36.99 $44.99 $55.99 $70.99 $79.99
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Benefits and Features

Popular format is ideal for HSA, Archer MSA, and Medicare Advantage MSA Information.
Meets all government and IRS filing requirements.

  • Use to Report: Contributions to an HSA (including transfers and rollovers) or Archer MSA and the FMV of an HSA, Archer MSA or Medicare Advantage MSA.
  • Amounts to Report: All amounts.
  • Tax forms per sheet: Three filings per sheet.
  • Paper Filing Due Date: To IRS, May 31st // To Participant May 31st.