Tax5498SA_V100

XSD

    <xsd:complexType name="Tax5498SA_V100">
        <xsd:annotation>
            <xsd:documentation>Form 5498-SA - HSA, Archer MSA, or Medicare Advantage MSA Information</xsd:documentation>
        </xsd:annotation>

        <xsd:complexContent>
            <xsd:extension base="ofx:AbstractTaxForm5498Type">

        <xsd:sequence>

            <xsd:element name="TRUSTEEADDR" type="ofx:TrusteeAddressType" minOccurs="0"/>
            <xsd:element name="PARTICIPANTADDR" type="ofx:ParticipantAddressType" minOccurs="0"/>


            <xsd:element name="TRUSTEEID" type="ofx:GenericNameType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>TRUSTEE’S federal identification number</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="PARTICIPANTID" type="ofx:IdType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>PARTICIPANT'S social security number</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="ACCTNUM" type="ofx:GenericNameType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>Account number</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="MSACONTRIB" type="ofx:AmountType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>Box 1. Employee or self-employed person’s Archer MSA contributions made in 2017 and 2018 for 2017</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="TOTALCONTRIB" type="ofx:AmountType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>Box 2. Total contributions made in 2017</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="TOTALMADE" type="ofx:AmountType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>Box 3. Total HSA or Archer MSA contributions made in 2018 for 2017</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="ROLLOVER" type="ofx:AmountType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>Box 4. Rollover contributions</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:element name="FMV" type="ofx:AmountType" minOccurs="0">
                <xsd:annotation>
                    <xsd:documentation>Box 5. Fair market value OF HAS, Archer MSA, or MA MSA</xsd:documentation>
                </xsd:annotation>
            </xsd:element>

            <xsd:choice>
                <xsd:element name="HSA" type="ofx:BooleanType" minOccurs="0">
                    <xsd:annotation>
                        <xsd:documentation>Box 6a. HSA</xsd:documentation>
                    </xsd:annotation>
                </xsd:element>
                <xsd:element name="ARCHER" type="ofx:BooleanType" minOccurs="0">
                    <xsd:annotation>
                        <xsd:documentation>Box 6b. Archer MSA</xsd:documentation>
                    </xsd:annotation>
                </xsd:element>
                <xsd:element name="MAMSA" type="ofx:BooleanType" minOccurs="0">
                    <xsd:annotation>
                        <xsd:documentation>Box 6c. MA MSA</xsd:documentation>
                    </xsd:annotation>
                </xsd:element>
            </xsd:choice>

        </xsd:sequence>

           </xsd:extension>        
        </xsd:complexContent>

    </xsd:complexType>

OFX XML

<?xml version="1.0" encoding="UTF-8" standalone="no"?>
<?OFX OFXHEADER="200" VERSION="202" SECURITY="NONE" OLDFILEUID="NONE" NEWFILEUID="NONE"?>

<OFX>
    <SIGNONMSGSRSV1>
        <SONRS>
            <STATUS>
                <CODE>0</CODE>
                <SEVERITY>INFO</SEVERITY>
                <MESSAGE>Successful Login</MESSAGE>
            </STATUS>
            <DTSERVER>39210131000000</DTSERVER>
            <LANGUAGE>ENG</LANGUAGE>
            <FI>
                <ORG>fiName</ORG>
                <FID>fiId</FID>
            </FI>
        </SONRS>
    </SIGNONMSGSRSV1>
    <TAX5498MSGSRSV1>
        <TAX5498TRNRS>
            <TRNUID>_GUID_</TRNUID>
            <STATUS>
                <CODE>0</CODE>
                <SEVERITY>INFO</SEVERITY>
                <MESSAGE>SUCCESS</MESSAGE>
            </STATUS>
            <TAX5498RS>
                <TAX5498SA_V100>
                    <TAXYEAR>2020</TAXYEAR>
                    <TRUSTEEADDR>
                        <ADDR1>12020 Sunrise Valley Dr</ADDR1>
                        <CITY>Prescott</CITY>
                        <STATE>VA</STATE>
                        <POSTALCODE>20191</POSTALCODE>
                        <PHONE></PHONE>
                        <TRUSTEENAME1>Financial Data Exchange</TRUSTEENAME1>
                    </TRUSTEEADDR>
                    <PARTICIPANTADDR>
                        <ADDR1>1 Main St</ADDR1>
                        <CITY>Melrose</CITY>
                        <STATE>NY</STATE>
                        <POSTALCODE>12121</POSTALCODE>
                        <PARTICIPANTNAME1>Kris Q. Public</PARTICIPANTNAME1>
                    </PARTICIPANTADDR>
                    <TRUSTEEID>12-3456789</TRUSTEEID>
                    <PARTICIPANTID>XXX-XX-1234</PARTICIPANTID>
                    <ACCTNUM>123-1234567</ACCTNUM>
                    <MSACONTRIB></MSACONTRIB>
                    <TOTALCONTRIB>3000.00</TOTALCONTRIB>
                    <TOTALMADE>300.00</TOTALMADE>
                    <ROLLOVER>200.00</ROLLOVER>
                    <FMV>10000.00</FMV>
                    <HSA>Y</HSA>
                </TAX5498SA_V100>
            </TAX5498RS>
        </TAX5498TRNRS>
    </TAX5498MSGSRSV1>
</OFX>

FDX JSON

{
  "tax5498Sa" : {
    "taxYear" : 2022,
    "taxFormDate" : "2021-03-30",
    "taxFormType" : "Tax5498Sa",
    "trusteeNameAddress" : {
      "line1" : "12021 Sunset Valley Dr",
      "city" : "Preston",
      "state" : "VA",
      "postalCode" : "20191",
      "name1" : "Tax Form Issuer, Inc"
    },
    "trusteeTin" : "12-3456789",
    "participantTin" : "XXX-XX-1234",
    "participantNameAddress" : {
      "line1" : "1 Main St",
      "city" : "Melrose",
      "state" : "NY",
      "postalCode" : "12121",
      "name1" : "Kris Q. Public"
    },
    "accountNumber" : "123-1234567",
    "msaContributions" : 1000.0,
    "totalContributions" : 2000.0,
    "totalPostYearEnd" : 300.0,
    "rolloverContributions" : 400.0,
    "fairMarketValue" : 50000.0,
    "hsa" : true
  }
}