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Montana Free Printable  for 2019 Montana Montana Medical Care Savings Account

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Montana Medical Care Savings Account
Form MSA

CLEAR FORM MONTANA MSA Rev 09 17 2017 Montana Medical Care Savings Account Annual Reporting Information for Self-Administered Accounts 15-61-101 through 15-61-205, MCA First Name and Initial Last Name Social Security Number - - Name and address of the financial institution where your Montana medical care savings account is established: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Your Montana medical care savings account number: Part I. Allowable Deduction Calculation 1. Current year deposits (Column A if using MSA-Worksheet)........................ 1. 2. Deposits from prior years not previously deducted..................................... 2. 3. Add lines 1 and 2......................................................................................... 3. 4. Enter the lesser of the amount on line 3 or $3,000...................................................................4. 5. Interest and other income (Column B if using MSA-Worksheet)...............................................5. 6. Add lines 4 and 5. This is your Montana Medical Saving Account exclusion. Enter this amount on Form 2, Schedule II, line 18....................................................................................6. 7. If the amount on line 3 is greater than $3,000, subtract line 4 from line 3. These are your excess deposits that may be excluded next year.............................................7. Part II. Nonqualified Withdrawals 1. Nonqualified withdrawals (Column D if using MSA-Worksheet)................................................1. Enter this amount on Form 2, Schedule I, line 7. 2. Enter the withdrawals on line 1 made on the last business day in 2017 ����������������������������������2. 3. Subtract line 2 from line 1..........................................................................................................3. 4. Multiply the amount on line 3 by 10% (0.10). Enter this amount on Form 2, line 68, and write “MSA” in the space provided. This is your penalty............................................................4. The Montana Medical Care Savings Account Worksheet (MSA-Worksheet) is available to help you reconcile the activity on this form by providing a log to track expenses, deposits, withdrawals, fees and other transactions. It is not required to be completed or included with your tax return. (You can find the MSA-Worksheet at the end of the instructions.) If you file your Montana tax return electronically, you do not need to mail this form to us unless we ask you for a copy. When you file electronically, you represent that you have retained the required documents in your tax records and will provide them upon the department’s request. Form MSA Instructions Purpose of this form. A resident who establishes a medical savings account (or whose employer establishes an account for them) to pay for their own medical expenses and those of their spouse and qualifying children, is allowed to exclude contributions of up to $3,000 plus interest and other income earned on the account annually in determining their Montana adjusted gross income. This form needs to be included each year with the account holder’s individual income tax return. Definitions Account holder is a Montana resident who establishes a Montana medical care savings account. Dependent means your spouse and your qualified children. Your child qualifies as a dependent when the child is: ●● Under the age of 19; or ●● Under the age of 23 and enrolled as a full-time student at an accredited college or university; or ●● Legally entitled to the provision of proper or necessary subsistence, education, medical care, or other care necessary for the child’s health, guidance or well-being (for example, under a child support agreement) and the child is not otherwise married, self-supporting, emancipated, or a member of the armed forces; or ●● Mentally or physically incapacitated to the extent that the child is not self-sufficient. Eligible medical expenses are medical expenses, defined under Internal Revenue Code at 26 U.S.C. 213(d), that you, as the account holder, pay for yourself, your spouse and your qualified children. Nonqualified withdrawals are any withdrawals from your account that are not used for eligible medical expenses. Frequently Asked Questions What is required to establish a Montana medical care savings account? Any Montana resident can establish a Montana medical care savings account. The account has to be held separately from other accounts and cannot be a joint account with your spouse or child. If you are married, both spouses can establish their own Montana medical care savings account and take advantage of the Montana tax benefit. Your account can be established with any financial or investment institution. Your Montana medical care savings account can be selfadministered or administered by a financial institution or an accountant. Most account holders self-administer their accounts and do not utilize a third-party administrator. When you self-administer your account, use Form MSA to report your deposits and withdrawals. How much can I contribute to my Montana medical care savings account this year and how much of this amount can I subtract from my federal adjusted gross income for 2017? There is no limit in any one year on the amount that you may deposit into your Montana medical care savings account, but there is a limit on the amount that you can exclude from your federal adjusted gross income to arrive at your Montana adjusted gross income. If your filing status is single, head of household or married filing separately, the maximum amount that you can exclude from your federal adjusted gross income in any one year is $3,000 plus the interest or other income earned on the account. If you are filing your return jointly with your spouse and both spouses have a Montana medical care savings account, the maximum amount that you can exclude from your federal adjusted gross income is $6,000 plus the interest or other income earned on both accounts. What happens if I don’t use the entire amount I deposited in my Montana medical care savings account this year for medical expenses? There is no limit on the amount of funds and interest or other income on those funds that can be retained tax-free within your account. For example, if you deposited $500 in your account this year, but withdrew $100 to pay for eligible medical expenses this year, your remaining balance of $400 can be used to pay for future eligible medical expenses. How do contributions to my account affect my Montana taxable income? You reduce your Montana taxable income in the year you make a contribution by the lesser of the amount you contribute to the account or $3,000. The reduction is based on the amount you contribute, not the amount you pay for medical expenses. If you contributed $500, but paid only $100 for expenses in the current tax year, you would reduce your Montana adjusted gross income by $500 even though you have not used the entire amount. In the following tax year, if you don’t deposit any additional amounts in your account, but you use the remaining $400 for eligible medical expenses, your Montana taxable income will not be affected. You cannot claim an itemized deduction for medical expenses you pay from your account in either year. I have a federal health savings account established with my employer. Can I also have a Montana medical care savings account? Yes. The fact that you have a health savings account and are allowed a federal itemized deduction for contributions made to the account does not prevent you from establishing a separate Montana medical care savings account and making qualifying contributions to it. These accounts have to be maintained separately and the funds cannot be commingled. I paid several eligible medical bills from my regular checking account in 2017. Can I reimburse myself for these amounts from my Montana medical care savings account? If I can, how soon do I have to withdraw funds from my Montana medical care savings account and deposit them in my checking account? You can reimburse yourself from the medical savings account for eligible medical expenses you paid, even if the expenses were incurred before you established the account. You have until December 31, 2017 to withdraw funds from your Montana medical care savings account to reimburse yourself for funds withdrawn from your checking account. However, if the eligible medical expenses were paid after December 1, 2017, you have until January 15, 2018 to withdraw funds to reimburse yourself. I have a Montana medical care savings account. I withdrew funds during 2017 that were not used for eligible medical expenses. Are there any penalties that I have to pay because of this withdrawal? When you withdraw funds from your Montana medical care savings account for some purpose other than payment of eligible medical expenses, you incur a 10% penalty on these withdrawals, unless you withdraw them on the last business day of your tax year. You will need to complete Part II of this form to calculate your penalty. In all cases, your nonqualified withdrawals are considered ordinary income in the year that you withdraw the funds and are included as an addition to federal adjusted gross income in calculating your Montana adjusted gross income. What records do I have to maintain to verify that my withdrawals from my Montana medical care savings account were used for eligible medical expenses? You will need to maintain documentation that proves that your withdrawals in 2017 were used to pay (either as a reimbursement or a direct payment) for eligible medical expenses in 2017 for yourself, your spouse and your eligible dependents. Examples include, but are not limited to, medical receipts, bills and pharmacy receipts. If I move out of state, what happens to my medical care savings account? Only residents of Montana are eligible to receive tax benefits from the Montana medical savings accounts. As a result, any funds previously deducted and unused for eligible medial expenses by the date you become a nonresident are taxable and must be recaptured on your partyear resident individual income tax return. You do no have to close the account. However, you may not deduct any contribution made to this account after moving out of Montana. Important Changes to the MSA Starting in 2018 Changes to the Montana Medical Care Savings Account Act were passed by the 2017 Montana Legislature. These changes are effective for tax year 2018. The following overview of the changes to the act is provided for informational purposes only and cannot be used to determine your 2017 deduction. Contributions limited to deductible amount. Beginning with tax year 2018, the amount you can contribute to your MSA during the year is limited to the amount you can deduct. The contribution amount is limited to $3,500 in 2018 and increased to $4,000 in 2019. Although you are no longer able to make a contribution in excess of the amount you are eligible to deduct from gross income, if you contributed more to your MSA in 2017 than the amount you were able to deduct, you may still use the excess as a contribution made in 2018. This is the last time a carryover is possible. Inheritance of an account. An immediate family member who inherits an MSA can use the funds for eligible medical expenses of the deceased without penalties with the first year of the death. In addition, this immediate family member may inherit the MSA tax free, provided all the MSA requirements are met, including Montana residency. Eligible medical expenses. Eligible medical expenses are no longer limited to expenses paid for the employee, the account holder or a dependent. You may also use your MSA funds for long-term care expenses, including insurance or reimbursement of time used for family leave. Annual reporting. Beginning with tax year 2018, employee or account holders are required to report the starting balance and the ending balance of their account on the Form MSA. Administrative Rules of Montana: 42.15.601 through 42.15.605 Questions? Call us at (406) 444-6900 or access the Montana State University Extension MontGuide at www. msuextension.org/health/msu_montguides.html. Montana Medical Care Savings Account Worksheet (MSA-Worksheet) Account Holder_________________________________________________________________ Financial Institution______________________________________________________________ Account Number_____________________________________________ For Year Ended____________________ Expenses Paid or Reimbursed Date Description Amount Totals Paid directly from MSA? Reimbursed from MSA? Date Reimbursed Deposits, Withdrawals and Other Transactions Date Column A Deposit Amount Description Column B Interest and Other Income Column C Qualified Withdrawals Column D Nonqualified Withdrawals Column E Fees and Other Charges Totals Account Reconciliation 1. Beginning balance (If this is a new account, enter 0)......................................................................... 1. 2. Total deposits (Column A)........................................................................................ 2. 3. Total interest and other income (Column B)............................................................. 3. 4. Add lines 2 and 3................................................................................................................................ 4. 5. Total withdrawals (Add Columns C and D)............................................................... 5. 6. Total fees and other charges (Column E)................................................................. 6. 7. Add lines 5 and 6................................................................................................................................ 7. 8. Ending balance. Add lines 1 and 4 and subtract line 7...................................................................... 8. The worksheet is provided to help you track and record the information related to your medical savings account. You are not required to use this worksheet nor include a copy when you file your income tax return. If your tax return is selected for review because you claimed the deduction for deposits into a medical savings account, this worksheet can be submitted as a summary. However, you may still be asked to provide other information such as copies of bank statements and canceled checks. Questions? Call us at (406) 444-6900 or access the Montana State University Extension MontGuide at www.msuextension.org/health/msu_montguides.html.
Extracted from PDF file 2017-montana-form-msa.pdf, last modified April 2014

More about the Montana Form MSA Corporate Income Tax

We last updated the Montana Medical Care Savings Account in January 2018, and the latest form we have available is for tax year 2017. This means that we don't yet have the updated form for the current tax year. Please check this page regularly, as we will post the updated form as soon as it is released by the Montana Department of Revenue. You can print other Montana tax forms here.

Other Montana Corporate Income Tax Forms:

TaxFormFinder has an additional 78 Montana income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form MSA Montana Medical Care Savings Account
Form INA-CT Affidavit of Inactivity for Corporations, Partnerships and Disregarded Entities
Form MT-R Reciprocity Exemption from Withholding for North Dakota residents who work in Montana
Form NOL Montana Net Operating Loss
CIT Corporate Income Tax Return (formerly CLT-4)

Download all MT tax forms View all 79 Montana Income Tax Forms


Form Sources:

Montana usually releases forms for the current tax year between January and April. We last updated Montana Form MSA from the Department of Revenue in January 2018.

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About the Corporate Income Tax

The IRS and most states require corporations to file an income tax return, with the exact filing requirements depending on the type of company.

Sole proprietorships or disregarded entities like LLCs are filed on Schedule C (or the state equivalent) of the owner's personal income tax return, flow-through entities like S Corporations or Partnerships are generally required to file an informational return equivilent to the IRS Form 1120S or Form 1065, and full corporations must file the equivalent of federal Form 1120 (and, unlike flow-through corporations, are often subject to a corporate tax liability).

Additional forms are available for a wide variety of specific entities and transactions including fiduciaries, nonprofits, and companies involved in other specific types of business.

Historical Past-Year Versions of Montana Form MSA

We have a total of seven past-year versions of Form MSA in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:



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