5498-SA 2016

What's New for 2016

Field Name	Size	Type	Description	Notes
See Form Filer Common Fields			Filer fields common to all form types.
See Recipient Common Fields			Recipient fields common to all form types.
Box 1 Amount	12	Amount	Box 1: Employee or self-employed person's Archer MSA contributions...
Box 2 Amount	12	Amount	Box 2: Total contributions made in 2015
Box 3 Amount	12	Amount	Box 3: Total HSA or MSA contributions made in 2016 for 2015
Box 4 Amount	12	Amount	Box 4: Rollover contributions
Box 5 Amount	12	Amount	Box 5: Fair market value of HSA, Archer MSA, or M+C MSA
Box 6 Checkbox 1	1	Checkbox	Box 6: HSA	X / Y / T / 1 = Checked
Box 6 Checkbox 2	1	Checkbox	Box 6: Archer MSA	X / Y / T / 1 = Checked
Box 6 Checkbox 3	1	Checkbox	Box 6: MA MSA	X / Y / T / 1 = Checked
See Form Common Fields			Form fields common to all form types.

IRS 5498-SA Form: 5498-SA Form