Forms › Form 5498-SA
Fill out Form 5498-SA free in your browser. The official IRS form opens here, you click each field and type, then download the finished PDF. Nothing is uploaded to any server, there is no signup, and there is no watermark.
Form 5498-SA reports contributions made to an HSA, Archer MSA, or Medicare Advantage MSA, along with the year-end fair market value of the account. It is filed by the account trustee or custodian (such as a bank or insurer), with a copy sent to the account holder.
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The HSA or MSA trustee or custodian files Form 5498-SA with the IRS and sends you a copy for your records. As the account holder, you generally do not attach it to your tax return; you use the information on it to report contributions and verify amounts.
Yes — completely free, with no signup and no watermark. You fill it in your browser and download it.
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Yes. This is the official, current Form 5498-SA published by the U.S. government, which is public domain. You fill the genuine document.