MSA Log: Montana Medical Care Savings Account (MSA) Log (Revision)
Montana · Montana DOR · Used for tax years 2024, 2025, 2026
The Montana Medical Care Savings Account (MSA) Log is an optional worksheet for recording account activity, including expenses paid or reimbursed, deposits, income, withdrawals, and fees. You do not need to include it with your income tax return.
Who files this form
Montana medical care savings account holders must keep records documenting account activity. This log is optional. You do not have to use it or include a copy with your income tax return.
What you'll need
To complete the log, have the following information available:
- Account holder name, financial institution, account number, and year ended.
- Dates, descriptions, and amounts of expenses paid or reimbursed, including whether they were paid directly from the MSA or reimbursed from it, and reimbursement dates.
- Dates, descriptions, and amounts for deposits, interest and other income, qualified and nonqualified withdrawals, and fees and other charges.
If your return is selected for review because you claimed a deduction for MSA deposits, you may be asked for copies of bank statements, cancelled checks, or other information.
How to file
You do not need to include this log with your income tax return. If your return is selected for review because you claimed the deduction for MSA deposits, you can submit the worksheet as a summary of account activity.
The form does not provide a mailing address or electronic submission instructions.
Common mistakes
- Not keeping account records. Account holders must maintain records documenting MSA activity, even though using this worksheet is optional.
- Assuming the log is enough for a review. You may still be asked for other information, such as bank statements and cancelled checks, even if you submit the log as a summary.
Questions people ask
Do I have to use this log?
No. The worksheet is optional, but Montana MSA holders must maintain records documenting account activity.
Do I need to attach the log to my income tax return?
No. The form says you are not required to include a copy when filing your return.
Can I use the log if my return is reviewed?
Yes. If your return is selected for review because you claimed the deduction for MSA deposits, you can submit the log as a summary. You may still be asked for bank statements, cancelled checks, or other information.
What activity can I track on the log?
You can record expenses paid directly or reimbursed from the MSA, deposits, interest and other income, qualified and nonqualified withdrawals, and fees and other charges.
Where can I find more information?
The form directs readers to the Montana State University Extension MontGuide titled Montana Medical Care Savings Accounts at https://extension-store.montana.edu.