CUSTODIAN TRANSACTION MAPPING FOR 5498-SA / 1099-SA
Account Reference:
Tax Year:

1. OUTBOUND WITHDRAWALS (Form 1099-SA)
[ ] Identify all gross distributions from the ledger.
[ ] Identify any direct trustee-to-trustee transfers out (Exclude from 1099-SA).
[ ] Identify any original withdrawals later reversed as accepted mistaken distributions (Exclude from 1099-SA).
[ ] Calculate Box 1 Gross Distribution (Ensure Box 2 earnings are included in this total).
[ ] Assign appropriate Box 3 code (1, 2, 3, 4, 5, or 6).

2. INBOUND DEPOSITS (Form 5498-SA)
[ ] Identify all current-year regular contributions received.
[ ] Identify all prior-year designated contributions physically received in the current calendar year.
[ ] Combine current-year and prior-year deposits received in-year for Box 2.
[ ] Identify subsequent-year contributions designated for the calendar year (Box 3).
[ ] Identify direct trustee-to-trustee transfers in (Exclude from 5498-SA).
[ ] Identify rollover check deposits (Report separately in Box 4).
[ ] Identify accepted mistaken distribution repayments (Exclude from 5498-SA).

3. FAIR MARKET VALUE
[ ] Determine Dec 31 Account FMV for Box 5.
[ ] If FMV is zero AND no contributions/rollovers occurred, verify if 5498-SA filing can be skipped.