IRS Approved 1099-SA Recipient Copy B Laser Tax Form - 100 Recipients

Perforation: Horizontal at 3 2/3" & 7 1/3"; Vertical at 1/2" from Right

File Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, to report distributions made from an HSA, Archer MSA, or Medicare Advantage MSA (MA MSA). The distribution may have been paid directly to a medical service provider or to the account holder. A separate return must be filed for each plan type.