Distributions From an Archer MSA or Medicare+Choice MSA

Distributions From an Archer MSA or Medicare+Choice MSA

OMB: 1545-1517

IC ID: 18577

Information Collection (IC) Details

View Information Collection (IC)

Distributions From an Archer MSA or Medicare+Choice MSA 1545-1517
 
No Modified
 
Mandatory
 
26 CFR 301.6109-4

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1099-SA Distributions From an HSA, Archer MSA or Medical Advantage MSA Form 1099-SA.pdf Yes Yes Fillable Fileable
Instruction Form 1099-SA Instructions.pdf Yes No Printable Only

General Government Taxation Management

 

10,336 0
   
Private Sector Businesses or other for-profits
 
   97 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 25,839 0 0 0 0 25,839
Annual IC Time Burden (Hours) 3,618 0 0 0 0 3,618
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Burden 1099-SA burden.PDF 01/24/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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