5498 Forms
![]() | 5126 - 5498-ESA Federal Copy A Used to report Contributions (including rollover contributions) to a Coverdell ESA. Three forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5127 - 5498 ESA Beneficiary Copy B Used to report Contributions (including rollover contributions) to a Coverdell ESA. Three forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5128 - 5498 ESA Trustee Copy C Used to report Contributions (including rollover contributions) to a Coverdell ESA. Three forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5133 - 5498 SA Copy A Federal Used to report Contributions to an HSA (including transfers and rollovers) of Archer MSA and the FMV of an HSA, Archer MSA or Medicare Advantage MSA. Three forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5134 - 5498 SA Participant Copy B Used to report Contributions to an HSA (including transfers and rollovers) of Archer MSA and the FMV of an HSA, Archer MSA or Medicare Advantage MSA. Three forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5135 - 5498 SA Trustee Copy C Used to report Contributions to an HSA (including transfers and rollovers) of Archer MSA and the FMV of an HSA, Archer MSA or Medicare Advantage MSA. Three forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5170 - 5498 Federal Copy A Contributions (including rollover contributions)to any individual retirement arrangement (IRA) including a SEP, SIMPLE and ROTH IRA; ROTH conversions; IRA re-characterizations and the fair market value (FMV) of the account. Two forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5171 - 5498 Participant Copy B Contributions (including rollover contributions)to any individual retirement arrangement (IRA) including a SEP, SIMPLE and ROTH IRA; ROTH conversions; IRA re-characterizations and the fair market value (FMV) of the account. Two forms per page. Sold in packs of 50 sheets. | ![]() |
![]() | 5172 - 5498 Trustee or Issuer and/or State Copy C. Contributions (including rollover contributions)to any individual retirement arrangement (IRA) including a SEP, SIMPLE and ROTH IRA; ROTH conversions; IRA re-characterizations and the fair market value (FMV) of the account. Two forms per page. Sold in packs of 50 sheets. | ![]() |