Form 8889 Examples Filled Out - Syair Sdy May 2026

Enter $1,000 (the amount used for qualified medical expenses).

$1,500 (Reported on Form W-2, Box 12, Code W) Distributions Taken: $1,000 (Reported on Form 1099-SA) Qualified Medical Expenses: $1,000 ✍️ How to Fill Out the Form Part I: Contributions and Deductions Line 1: Check the Family box. Line 2: Enter $3,000 (your out-of-pocket contributions). Form 8889 Examples Filled Out - Syair SDY

Enter $1,000 (the total distribution received from the HSA). Enter $1,000 (the amount used for qualified medical

Enter $0 (subtract line 15 from 14a. Because all funds were used on qualified expenses, no tax is owed). IRS Form 8889 walkthrough (Health Savings Accounts) 500 (Reported on Form W-2

Calculate your final HSA deduction to be carried over to your Form 1040. Part II: HSA Distributions