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5498 5498-ESA 5498-SA 1099-LTC 1099-SA
FORM 5498
IRA Contribution Information
The 5498 is used to report your individual retirement arrangement (IRA), simplified employee pension (SEP), or savings incentive match plan for employees (SIMPLE) to report contributions and the fair market value of the account.
5498 NON-MAILERS
TC58-3
TC58-3 TC58-3 TC58-3

Use DW19, DW19W, SW19, or DW19S, DW19WS Self-Seal Envelopes with this form.
 
T58-1, TC58-2
T58-1 T58-1 T58-1

Use DW19, DW19W, SW19, or DW19S, DW19WS Self-Seal Envelopes with this form.
 
FORM 5498 MAILERS
 
CONTINUOUS FORM NUMBERS
  FORM T58-1 1-PART
Carbonless FORM TC58-2 2-PART
  FORM TC58-3 3-PART
 
MAILER FORM NUMBERS
  FORM PTM58-3 3-PART PEEL-APART
Mag Media FORM PTM58-2 2-PART PEEL-APART
 
5498 ESA
Coverdell ESA Contribution Information.
Contributions (including rollover contributions) to a Coverdell ESA.
TC58ESA-3 TC58ESA-3 TC58ESA-3

Use DW19, DW19W, SW19, or DW19S, DW19WS Self-Seal Envelopes with this form.
CONTINUOUS FORM NUMBERS
Carbonless FORM TC58ESA-3 3-PART 5498 ESA FORM
 
5498 SA
HSA, Archer MSA, or Medicare+Choice MSA Information
TC58SA-4 TC58SA-4 TC58SA-4

Use DW19, DW19W, SW19, or DW19S, DW19WS Self-Seal Envelopes with this form.
CONTINUOUS FORM NUMBERS
Carbonless FORM TC58SA-4 4-PART 5498 SA FORM
 

1099 LTC
A payer such as an insurance company, must use this form for payments made under a long-term care insurance contract or for accelerated death benefits.
TC-LTC4 TC-LTC4 TC-LTC4

Use DW19, DW19W, SW19, or DW19S, DW19WS Self-Seal Envelopes with this form.
CONTINUOUS FORM NUMBERS
Carbonless FORM TC-LTC4 4-PART
 
1099 SA
The 1099-SA form is used to report distributions made from an HSA, Archer MSA, or Medicare Advantage MSA.
TC-SA4 TC-SA4 TC-SA4

Use DW19, DW19W, SW19, or DW19S, DW19WS Self-Seal Envelopes with this form.
CONTINUOUS FORM NUMBERS
Carbonless FORM TC-SA4 4-PART 1099 SA
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