Information Collection Request
Distributions From an HSA, Archer MSA, or Medicare Advantage MSA
ICR 202409-1545-014 · OMB 1545-1517 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 1099-SA Form 1099-SA - Distributions From an HSA, Archer MSA, or Medicare Advantage MSA |
Form | Modified | Repair queued |
 SUP STAT 1545-1517-final.docx |
Supporting Statement A | Uploaded 2025-03-04 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 18577 |  Form 1099-SA - Distributions From an HSA, Archer MSA, or Medicare Advantage MSA |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | TREAS/IRS |
| OMB Control No | 1545-1517 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202107-1545-012 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |