The IRS Form 1099‑SA is the official tax document used to report distributions from a Health Savings Account (HSA), Archer MSA, or Medicare Advantage MSA. Whether you took a qualified medical expense withdrawal or a non‑qualified distribution, the information must be reported to the IRS and to the account holder.
Formize provides a fillable PDF version of the 1099‑SA so you can complete it online, save a copy, and print or email it directly to the IRS—no additional PDF editor required.
The 1099‑SA captures the total amount distributed from your HSA during the tax year, the taxable portion, and any earnings that must be reported as income. The form is issued by the HSA trustee (bank, credit union, or other custodian) and must be attached to your individual tax return (Form 1040).
Instead of downloading the PDF and opening it in a separate editor, simply click the "Fill out this form" button on this page. The Formize PDF Filler app will load in your browser, letting you type directly into each field.
After you finish the form in Formize, you can:
Always keep a copy for your personal files in case the IRS requests additional documentation.
No. Formize’s online PDF filler lets you complete the form directly in your browser without any additional software.
Yes. The saved PDF remains fully editable in any standard PDF viewer, but it’s easier to make changes before downloading by using the Formize filler.
The payer must furnish the form to the recipient by January 31 and file with the IRS by February 28 (paper) or March 31 (electronic) of the following year.
Only non‑qualified withdrawals are taxable. Qualified medical expense distributions are tax‑free, but you still report them on the 1099‑SA.
Correct the error in the Formize filler, save a new version, and resend the corrected form to the IRS and the account holder. You may also need to file a corrected 1099‑SA (Form 1099‑SA Corrected).
Generally, you do not attach receipts with the 1099‑SA, but keep documentation of qualified expenses in case of an audit.
Yes. Form 1099‑SA covers distributions from HSAs, Archer MSAs, and Medicare Advantage MSAs.
Yes. Formize provides the fillable version at no cost; you only pay if you choose premium features like e‑signatures.
HSA distribution form yra viena iš mokesčių formų, kurios yra dokumentai, naudojami su mokesčiais susijusiai informacijai pranešti atitinkamai mokesčių institucijai. Yra įvairių tipų mokesčių formų, įskaitant federalines, valstijos ir vietines mokesčių formas, kurios gali skirtis priklausomai nuo mokesčių mokėtojo aplinkybių ir vietos.
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