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No. 5123:  1099-SA Federal Copy A

Item type:	Tax Forms
Description:	Printed in red drop out ink. Distributions from an HSA, Archer MSA or Medicare Advantage MSA Sold in packs of 50 sheets. 1 sheet equals 3 forms. This copy not used when filing electronically.
Size:	8 ½” x 11”

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Pricing:  (per package)

Qty.	Price
1-5	$12.17
6-10	$11.58
11-20	$10.83
21-40	$10.07

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Prices subject to change without notice.