Vita HSA Certificate
Leo Williams is single and 45 years old.
Leo works as an IT manager and his Form W-2 shows wages of $47,250.
Leo participated in his employer's self-only coverage High Deductible Health Plan (HDHP) all
year.
Leo does not have any other health coverage.
Leo has had an HSA for two years.
Leo's employer contributed $1,500 in 2017 to Leo's HSA.
In 2017, Leo's Aunt contributed $2,000 to Leo's HSA.
Leo is a U.S. citizen and has a valid Social Security number.
1. Is Leo an eligible individual for HSA purposes even though he did not make his own
contributions? - ANSYes (Correct)
Leo Williams is single and 45 years old.
Leo works as an IT manager and his Form W-2 shows wages of $47,250.
Leo participated in his employer's self-only coverage High Deductible Health Plan (HDHP) all
year.
Leo does not have any other health coverage.
Leo has had an HSA for two years.
Leo's employer contributed $1,500 in 2017 to Leo's HSA.
In 2017, Leo's Aunt contributed $1,900 to Leo's HSA.
Leo is a U.S. citizen and has a valid Social Security number.
2. What amount will Leo use to compute his HSA deduction on Form 1040, line 25? -
ANS$1900 (Correct)
Leo Williams is single and 45 years old.
Leo works as an IT manager and his Form W-2 shows wages of $47,250.
Leo participated in his employer's self-only coverage High Deductible Health Plan (HDHP) all
year.
Leo does not have any other health coverage.
Leo has had an HSA for two years.
Leo's employer contributed $1,500 in 2017 to Leo's HSA.
In 2017, Leo's Aunt contributed $2,000 to Leo's HSA.
Leo is a U.S. citizen and has a valid Social Security number.
3. Employer contributions to Leo's HSA are reported on his Form W-2, box 12, code W. -
ANSTrue (Correct)
Ed and Christine are married and will file a joint return.
Ed is 47 years old, and Christine is 56 years old.
Both were enrolled in self-only coverage High Deductible Health Plans (HDHPs) through their
employers for the entire year of 2017.
Leo Williams is single and 45 years old.
Leo works as an IT manager and his Form W-2 shows wages of $47,250.
Leo participated in his employer's self-only coverage High Deductible Health Plan (HDHP) all
year.
Leo does not have any other health coverage.
Leo has had an HSA for two years.
Leo's employer contributed $1,500 in 2017 to Leo's HSA.
In 2017, Leo's Aunt contributed $2,000 to Leo's HSA.
Leo is a U.S. citizen and has a valid Social Security number.
1. Is Leo an eligible individual for HSA purposes even though he did not make his own
contributions? - ANSYes (Correct)
Leo Williams is single and 45 years old.
Leo works as an IT manager and his Form W-2 shows wages of $47,250.
Leo participated in his employer's self-only coverage High Deductible Health Plan (HDHP) all
year.
Leo does not have any other health coverage.
Leo has had an HSA for two years.
Leo's employer contributed $1,500 in 2017 to Leo's HSA.
In 2017, Leo's Aunt contributed $1,900 to Leo's HSA.
Leo is a U.S. citizen and has a valid Social Security number.
2. What amount will Leo use to compute his HSA deduction on Form 1040, line 25? -
ANS$1900 (Correct)
Leo Williams is single and 45 years old.
Leo works as an IT manager and his Form W-2 shows wages of $47,250.
Leo participated in his employer's self-only coverage High Deductible Health Plan (HDHP) all
year.
Leo does not have any other health coverage.
Leo has had an HSA for two years.
Leo's employer contributed $1,500 in 2017 to Leo's HSA.
In 2017, Leo's Aunt contributed $2,000 to Leo's HSA.
Leo is a U.S. citizen and has a valid Social Security number.
3. Employer contributions to Leo's HSA are reported on his Form W-2, box 12, code W. -
ANSTrue (Correct)
Ed and Christine are married and will file a joint return.
Ed is 47 years old, and Christine is 56 years old.
Both were enrolled in self-only coverage High Deductible Health Plans (HDHPs) through their
employers for the entire year of 2017.
