5 "0", "0", "FEDERAL CREDIT UNION","123 MAIN STREET","MADISON","WI","53703","00-1234567","111-22-3333","ADAM JONES","111 JOHNSON AVENUE","DE FOREST","WI","53532","ACCT1","1","2","3","4","1","0","0" "0", "0", "FEDERAL CREDIT UNION","123 MAIN STREET","MADISON","WI","53703","00-1234567","222-33-4444","BRIAN DAVIDSON","222 BREEZE TERRACE","BELOIT","WI","53511","ACCT2","1","2","3","4","1","0","0" "0", "0", "FEDERAL CREDIT UNION","123 MAIN STREET","MADISON","WI","53703","00-1234567","333-44-5555","CARL SMITH","333 FULLBRIGHT ROAD","JANESVILLE","WI","53512","ACCT3","1","2","3","4","1","0","0" "0", "0", "FEDERAL CREDIT UNION","123 MAIN STREET","MADISON","WI","53703","00-1234567","444-55-6666","DAVID GROVE","444 CASTLEROCK STREET","MADISON","WI","53703","ACCT4","1","2","3","4","1","0","0" "0", "0", "FEDERAL CREDIT UNION","123 MAIN STREET","MADISON","WI","53703","00-1234567","555-66-7777","EDWARD ROTH","555 NEWBERRY CIRCLE","JEFFERSON","WI","53533","ACCT5","1","2","3","4","1","0","0" Each column has to be read in the correct sequence. The 1st column of your data identifies whether this information return is Void. The 2nd column has a value for Corrected and so forth following in the order below for the 1099-SA: Void Corrected Payer Name Payer Address Payer City Payer State Payer Zip Payer Federal Identification number Recipient Federal Identification number Recipient Name Recipient Address Recipient City Recipient State Recipient Zip Account number S_1 // gross distribution S_2 // earnings on excess cont. S_3 // distribution code S_4 // fmv on date of death S_5_HSA S_5_Archer_MSA S_5_MA_MSA Type of TIN is taken from the TIN itself. If the TIN contains one dash (-), then the TIN type is EIN. If the TIN contains two dashes, then the TIN type is an SSN. Otherwise the TIN is identified as unknown.