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BMSB Custom Super Forms 9380 Form 5498 SA HSA Archer MSA or Medicare Advantage MSA Information Copy B Participant P16159237BMSB-9380-BLACKINK https://cdnimages.opentip.com/full/BMSB/BMSB-9380.jpg Custom Super Forms 9380 Form 5498 SA HSA Archer MSA or Medicare Advantage MSA Information Copy B Participant HSA, Archer MSA, or Medicare Advantage MSA Information. Use Form 5498-SA Copy B to print and mail payment information to the recipient. 5498-SA Forms are 3up on an 8 1/2 x 11\" sheet with a 1/2\" side perforation and are printed on 20# laser paper. Mail to the recipient in compatible window envelopes. Order by number of forms, not sheets. Compatible Envelopes: 99DWENV05 (Moisture Seal) | 99DWENVS05 (Self Seal) | 99DWENVSTE (Self Seal Tamper Evident) 16159237 0.0600lbs 0.00 0.00 0.00
Super Forms
1.5 2026-04-25 In Stock

Custom Super Forms 9380 - Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information Copy B Participant

Brand Super Forms
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SKU: BMSB-9380
Price: $0.06
Min.Order Price: $1.50 for 25 units
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*  Price Note: This is an estimate price of custom item. The actual price will be displayed after you design online.
* This item must be ordered in multiples of 25.
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Product Description

HSA, Archer MSA, or Medicare Advantage MSA Information. Use Form 5498-SA Copy B to print and mail payment information to the recipient. 5498-SA Forms are 3up on an 8 1/2 x 11" sheet with a 1/2" side perforation and are printed on 20# laser paper. Mail to the recipient in compatible window envelopes. Order by number of forms, not sheets.

Compatible Envelopes: 99DWENV05 (Moisture Seal) | 99DWENVS05 (Self Seal) | 99DWENVSTE (Self Seal Tamper Evident)

NOTE: It is important to keep in mind that this price is just for blank products. After you finish your design online and add to cart, you will see your setup fee and final price.
  • For printing decoration, additional locations/colors may incur additional fee.
  • Industry damage allowance is 2% of order, at least one piece. We would refund the damaged pcs if there any. Please order extra pieces as need.

warning tips WARNING: This product can expose you to chemicals which are known to the State of California to cause cancer, birth defects, or other reproductive harm. For more information, go to www.p65warnings.ca.gov.

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This item is non-returnable.
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