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Form 5305B: Health Savings Trust Account
IRS Form 5305-B is a model trust account agreement for health savings accounts, used by account owners and trustees. The maximum annual contribution limit for single coverage is $3,050 in 2011.
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IRS Form 5305B - Health Savings Trust Account
IRS Form 5305-B is a model trust account agreement for health savings accounts, used by account owners and trustees. The maximum annual contribution limit for single coverage is $3,050 in 2011.
Risk Radar
Scan points- 1Missing the required signatures of both the account owner and trustee invalidates the HSA.
- 2Omitting the account owner's date of birth from the form on page 1
- 3Leaving the trustee's name and principal place of business blank
- 4Failing to obtain signatures from both the account owner and trustee
- 5Using a version of the form other than the Rev. October 2016 edition
Plain English
Form 5305-B is a model trust agreement that establishes a health savings account. The account owner and trustee must sign it, and the account is used to pay qualified medical expenses. It includes contribution limits and rollover rules, and the executed form is kept with the account owner's records rather than filed with the IRS.
Submission Date
- Filing date: 2017-02-08 00:00:00
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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Glossary Terms
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What this form is for
- Use this form when you are establishing a health savings trust account for an eligible individual.
- Do not use it when the account is not a trust account or when the individual does not meet HSA eligibility requirements.
- Check Form 5305-B instead when you need a model trust account agreement approved by the IRS.
Form selector
Use this form or another form?
Opening a new health savings trust account
Provides the IRS‑approved trust agreement
✓ Confirm both account owner and trustee sign
Adding contributions to an existing HSA
Trustee must accept contributions per agreement
✓ Verify contribution does not exceed limit
Designating a beneficiary upon death
Determines whether HSA continues or is taxed
✓ Review Article VII provisions
Deadline or filing window
The form itself has no filing deadline; it may be completed at any time during the tax year. Contributions must be made before the deadline for filing the account owner’s federal income tax return for that year (without extensions).
Checklist
What you need before filling it out
Account owner name
Legal name of the grantor · Form 5305-B page 1
Date of birth
Birth date of account owner · Form 5305-B page 1
Address
Street, city, state, ZIP · Form 5305-B page 1
Trustee name
Name of trustee · Form 5305-B page 1
Trustee address
Principal place of business · Form 5305-B page 1
Initial contribution
Dollar amount assigned to trust · Form 5305-B page 1
Before you submit
- 1Confirm the account owner’s name, date of birth, and address are entered correctly
- 2Ensure the trustee’s name and principal place of business are provided
- 3Verify the initial contribution amount is specified in dollars
- 4Check that the account owner meets all four eligibility criteria (HDHP coverage, no other health plan, not enrolled in Medicare, not a dependent)
- 5Confirm the form is dated and signed by both account owner and trustee
- 6Include witness signature only if required
- 7Make sure the form is not filed with the IRS; keep it with your records
- 8Review Article VII to understand beneficiary provisions
How to file this form
- 1Obtain Form 5305-B and read the instructions
- 2Complete the account owner information
- 3Complete the trustee information
- 4Specify the initial contribution amount
- 5Sign and date the form with the trustee
- 6Store the signed form with your tax records as proof of establishment
Known limitations
- 1Not for use with Archer MSAs
- 2Not for accounts established outside the United States
- 3Not for individuals enrolled in Medicare
- 4Not for individuals claimed as a dependent
Field map
Compact field-by-field guide
General Info
2 items
Full legal name and taxpayer identification number (SSN or EIN).
Current mailing address.
Details
2 items
Complete all applicable sections of this form according to the official IRS instructions.
Enter the relevant dollar amount if this form involves tax calculation.
Certification
1 items
Read and acknowledge any certifications required by this form.
Signatures
1 items
Sign and date. Unsigned forms cannot be processed.
Almost done reviewing the fields?
Fillable formOpen in Editor->The current edition is Form 5305-B (Rev. October 2016). The source does not reference a separate “latest information” page; the only change noted is the increase of the additional tax on non‑qualified distributions from 10% to 20% for tax years beginning after December 31, 2010.
What changed or needs a fresh check
- Edition date — confirm the revision is October 2016
- Fee — no fee is stated in the source
- Mailing address — not stated in the source
- Signature — both account owner and trustee must sign; witness signature only if required
Quick Facts
Downloads
After you file
- 1Retain the executed Form 5305-B with your tax records indefinitely
- 2Keep records of contributions and distributions to substantiate tax‑free status
- 3Monitor contributions to ensure they do not exceed the annual limit
- 4If an error is discovered, contact the trustee to amend the agreement
- 5Review the trust agreement annually for any changes in tax law
Sources
- SRCForm p.1 — account owner must be covered by a high deductible health plan (HDHP)
- SRCForm p.1 — account owner must not be covered by any other non‑HDHP plan
- SRCForm p.1 — account owner must not be enrolled in Medicare
- SRCForm p.1 — account owner cannot be claimed as a dependent
- SRCForm p.2 — additional tax on non‑qualified distributions increases from 10% to 20% for tax years after 2010
- SRCForm p.2 — do not file Form 5305-B with the IRS
- SRCForm p.2 — the account must be created in the United States
- SRCForm p.2 — each eligible spouse must establish a separate HSA
Common confusion points
Do I need to file Form 5305-B with the IRS?
The form is a model agreement, not a return
→ Check the instructions: Do not file with IRS
What if I am covered by a non‑HDHP?
Eligibility requires HDHP coverage
→ Verify you are covered only by an HDHP
Can I contribute more than the limit?
Contributions are capped
→ Check the annual contribution limit
What happens if I take a non‑qualified distribution?
Additional tax applies
→ Confirm distribution is for qualified medical expenses
Who can be a beneficiary?
Spouse vs. other beneficiaries
→ Review Article VII
Do I need a witness signature?
Only if required by trustee
→ Check if witness signature is needed
Is an EIN required?
Only for certain HSAs
→ Determine if you need an EIN
Workflow map
Related forms and next steps
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Current
After
Often used with
⚠ If something goes wrong
- Form 5305-B — refer to instructions for corrections
Questions about IRS Form 5305B
What is IRS Form 5305B used for?
Form 5305-B is a model trust agreement that establishes a health savings account. The account owner and trustee must sign it, and the account is used to pay qualified medical expenses. It includes contribution limits and rollover rules, and the executed form is kept with the account owner's records rather than filed with the IRS.
Who must file IRS Form 5305B?
The account owner (grantor) and the trustee must sign and execute the form.
What information does IRS Form 5305B require?
The form collects the account owner's name, date of birth, and address, as well as the trustee's name and principal place of business.
Where do I file IRS Form 5305B?
Do not file Form 5305-B with the IRS; keep it with your records.
How do I complete IRS Form 5305B?
The account owner's name, date of birth, and address are entered first, followed by the trustee's name and principal place of business. Both the account owner and the trustee must sign and date the agreement. A witness signature is optional unless required by state law. The executed form is kept with the account owner's records and is not filed with the IRS.
What happens if IRS Form 5305B is filed incorrectly?
Excess contributions are subject to an excise tax, and distributions not used for qualified medical expenses incur a 20% additional tax.
Do I need to file Form 5305-B with the IRS?
The form is a model agreement, not a return Check the instructions: Do not file with IRS
What if I am covered by a non‑HDHP?
Eligibility requires HDHP coverage Verify you are covered only by an HDHP
Source transparency
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