Information Collection

HSA, Archer MSA, or Medicare Advantage MSA Information

IC 18582 under ICR 200808-1545-019 · OMB 1545-1518.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-1518 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information	Form
08 Draft 1099 General Instructions.pdf	Instruction
5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information 08 Draft Form 5498-SA.pdf	Form
brdn_spec.pdf Burden Computation	IC Document

IC Title:

HSA, Archer MSA, or Medicare Advantage MSA Information

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5498-SA	HSA, Archer MSA, or Medicare Advantage MSA Information	08 Draft Form 5498-SA.pdf		Yes	Yes	Fillable Fileable
Instruction			08 Draft 1099 General Instructions.pdf		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16,442

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	41,105	41,105
Annual IC Time Burden (Hours)	6,988	6,988
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden Computation	brdn_spec.pdf	08/19/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.