Table of Contents

• General Instructions
  • What's New
  • Purpose of Form
  • Who Must File
  • Definitions
• Specific Instructions
  • Part I—HSA Contributions and Deductions
    • Figuring Your HSA Deduction
    • How To Complete Part I
    • Line 1
    • Line 2
    • Line 3
    • Line 6
    • Line 7
    • Line 9
    • Line 10
    • Line 13
  • Part II—HSA Distributions
    • Line 14a
    • Line 14b
    • Line 15
    • Lines 17a and 17b
  • Part III—Income and Additional Tax for Failure to Maintain HDHP Coverage
    • Line 18
    • Line 19