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Tax Forms 4 Us
P.O. Box 681
Tarrytown, NY 10591


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(800) 544-3427

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5123 - 1099-SA Copy A Federal

5123 - 1099-SA Copy A Federal

SA Distributions from HSA or Medicare Advantage MSA. Printed in red drop out ink. This form is not required when filing electronically. Three forms per page. Sold in packs of 50 sheets.



Size: 8 1/2" x 11"

Pricing:

Qty. Price
1 - 5$18.33
6 - 10$17.44
11 - 20$16.31
21 +$15.15