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TOPS® 5498ESA Form, 1 Part, Trustee/State, HSA, Archer MSA, or Medicare Advantage MSA Info, Copy C, 50 Sheets/Pack

Item: 920034   Model: L5498SAPAY
$6.19 50/Pack

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  • 50 sheets per pack
  • Laser printer compatible
  • Size 8 1/2" x 11"

5498SA HSA, Archer MSA, or Medicare Advant. MSA Information - 1 part laser cut sheet Copy C form. Laser printer compatible. Size: 8 1/2" x 11".

  • 50 sheets per pack
  • Laser printer compatible
  • Size 8 1/2" x 11"
  • Printed in black ink
  • Includes one W-3 and 1096 Transmittal form

Form FormatLaser

Tax Form Pack Size50

Tax Form TypeW-3

Tax Forms Number of Recipient or Employees26-50

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