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Templates
Government forms
Form 4255 - Dec 2016

Government forms

Form 4255 - Dec 2016

Recapture of Investment Credit

Form 4255 is used to report the tax on excess contributions to a health savings account.

Originally published by: irs.gov

Used 5 times

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Frequently asked questions

IRS Form 4255 is used by taxpayers who have made excess contributions to a health savings account and need to report and pay the associated tax. The form calculates the amount of tax owed based on the excess contribution and the number of months the excess contribution remained in the account. Taxpayers should fill out this form and include it with their tax return to report the excess contribution and pay the tax.
Taxpayers with excess contributions to a health savings account
The completed Form 4255 must be attached to your tax return and filed with IRS.

Used 5 times