Do I file Form 8853 separately?

No. Attach Form 8853 to the taxpayer’s Form 1040 (or other return) for the year in which the contributions, distributions, or premiums apply; follow the same filing method as the return.

Can Form 8853 be signed electronically?

Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where applicable, provided intent, consent, attribution, and record retention are documented.

What if the TIN is incorrect?

An incorrect TIN can trigger backup withholding and IRC §6721 penalties; correct errors promptly using the IRS procedures and, if required, file corrected information returns.

How long must I keep supporting records?

Retain supporting documentation for at least 3 years from filing per IRC §6501(a); longer retention may apply for HIPAA or state-specific rules.

When should I seek professional review?

Obtain tax or legal review for complex distributions, corrections, or when there is uncertainty about the taxability of long-term care contract items.

What authentication is recommended for eSign?

Use multi-factor authentication (email + SMS or KBA) for higher assurance, and ensure the platform captures an audit trail with IP, timestamp, and signer attribution.

Electronic Signature
Templates
Insurance
Form 8853 Archer MSAs and Long Term Care Insurance Contracts

Form 8853 Archer MSAs and Long Term Care Insurance Contracts

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

What Form 8853 is and when it applies

Form 8853, Archer MSAs and Long-Term Care Insurance Contracts, is an IRS information return used by taxpayers to report Archer Medical Savings Account (MSA) contributions and distributions and to report certain long-term care insurance contract items that affect federal income tax. Taxpayers use it to calculate taxable and nontaxable portions of MSA distributions, report employer and employee contributions, and reconcile any long-term care contract premiums or benefits with income tax rules. The form is prepared for inclusion with Form 1040 (or the applicable return) and retained with tax records.

Why accurate completion matters for taxes and compliance

Accurate entry on Form 8853 ensures correct taxable income calculation for Archer MSAs and proper reporting of long-term care contract items to the IRS.

Who typically prepares and signs Form 8853

Payroll and benefits administrators, tax preparers, and individual taxpayers complete Form 8853 when Archer MSA activity or long-term care contract reporting is present on the federal return.

Tax preparers preparing individual returns and information returns for clients
Employers or benefits teams reporting employer MSA contributions
Individuals who made Archer MSA contributions or received MSA distributions

Step-by-step: completing and attaching Form 8853

Follow these core steps to prepare Form 8853, reconcile figures, and file with your individual return or the preparer’s workflow.

01

Gather records: Collect MSA statements, insurer premium reports, and employer contribution data.
02

Complete form: Enter taxpayer details, contributions, distributions, and premium information.
03

Calculate taxable amounts: Use worksheet rules on the form to determine includible income.
04

Attach and file: Attach Form 8853 to Form 1040 when filing electronically or on paper.

Where Form 8853 goes and how it is transmitted

Form 8853 is included with the individual tax return and transmitted under the same filing method: e-file via tax software or paper filing with Form 1040.

Attach to Form 1040: Include Form 8853 with the taxpayer’s Form 1040 or applicable return.
E-file submission: Transmit via IRS-authorized e-file providers when the return is filed electronically.
Paper filing: Mail the full return and attached schedules per IRS paper filing instructions.
Record retention: Keep copies and supporting documentation for the retention period required by law.

Configuring a digital workflow for Form 8853

Set up fields, signer order, and authentication to capture required information and a durable audit trail for tax records.

Field	Configuration
Signature Type	Typed or drawn signature with audit trail
Authentication	Email plus SMS code or KBA for higher assurance
Conditional Fields	Show distribution fields only when distributions reported
Retention Policy	Automatic export to secure storage for required retention period

Technical requirements for eSubmission and eSignatures

Use a platform that supports PDF, Word, and audit-trail export, and that can meet regulatory retention and authentication needs.

File types supported: PDF, DOCX, XLSX
Integrations: Salesforce, NetSuite, Google Workspace
Authentication: Email, SMS, KBA options

Key filing deadlines and timing implications

Timely filing of Form 8853 depends on the taxpayer’s return due date and applicable extensions; late or missing information returns may trigger penalties.

Form 1040 due date:

April 15 is the typical deadline for the individual return

Extension deadline:

Form 4868 extends filing to Oct 15 for the return, not payment

Amendment window:

Amend within 3 years to claim refunds per IRC §6501(a)

Record retention start:

Retention periods run from filing or creation date as applicable

Information penalties:

Late or incorrect returns can trigger IRC §6721 penalties

Penalties and tax risks from incorrect or missing Form 8853 data

Incorrect TIN: Backup withholding risk; 24% rate

Late filing: IRC §6721 penalties per return

Underreported income: Tax plus interest and potential accuracy-related penalties

Intentional disregard: Higher IRC §6721 fines, no maximum

Missing documentation: Increased audit risk

Privacy breach: HIPAA or state privacy exposure for health data

Common errors to avoid when preparing Form 8853

Mismatched names or TINs between Form 8853 and Form 1040 leading to processing delays and possible withholding
Failing to separate employer versus employee Archer MSA contributions, which affects exclusion calculations
Omitting dates or amounts for distributions that determine taxable versus nontaxable portions of the MSA
Relying on scanned handwritten forms without a clear audit trail or signer authentication for electronic records

Core sections and components of Form 8853

Form 8853 is structured to capture the main elements necessary to calculate taxable amounts and report long-term care contract items; understand each part before completing.

Taxpayer Details

Identifying information used to match Form 8853 to the individual return, including name and TIN to ensure correct IRS processing.

Archer MSA Contributions

Lines to report employer and employee contributions and to compute the allowable deduction or applicable exclusion from income.

Distributions

Fields to report total distributions, amounts used for qualified medical expenses, and portions that are taxable.

Long-Term Care Items

Section for reporting payments, premiums, or benefits from qualified long-term care insurance contracts affecting tax treatment.

Worksheets

Built-in worksheets to calculate taxable portions, penalties, and amounts carried to the individual return.

Preparer Info

Space for the tax return preparer’s signature, identifying information, and declarations when applicable.

Essential data elements to capture on the form

Taxpayer Name: Full legal name

SSN or TIN: Nine-digit TIN

Contribution Totals: Employer and employee amounts

Distribution Totals: Total MSA distributions

Premiums Reported: Long-term care premiums

Preparer Details: Preparer name and PTIN

Sample eSignature vendor pricing comparison for tax form workflows

Compare common vendor starting prices and core attributes relevant to signing and storing Form 8853; signNow is listed first per comparison convention.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

FAQs: common questions about Form 8853 and electronic signing

Answers to frequent questions on completion, filing, and eSignature compliance for Form 8853 and related records.

Need help? Contact support

Do I file Form 8853 separately?
No. Attach Form 8853 to the taxpayer’s Form 1040 (or other return) for the year in which the contributions, distributions, or premiums apply; follow the same filing method as the return.
Can Form 8853 be signed electronically?
Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where applicable, provided intent, consent, attribution, and record retention are documented.
What if the TIN is incorrect?
An incorrect TIN can trigger backup withholding and IRC §6721 penalties; correct errors promptly using the IRS procedures and, if required, file corrected information returns.
How long must I keep supporting records?
Retain supporting documentation for at least 3 years from filing per IRC §6501(a); longer retention may apply for HIPAA or state-specific rules.
When should I seek professional review?
Obtain tax or legal review for complex distributions, corrections, or when there is uncertainty about the taxability of long-term care contract items.
What authentication is recommended for eSign?
Use multi-factor authentication (email + SMS or KBA) for higher assurance, and ensure the platform captures an audit trail with IP, timestamp, and signer attribution.

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