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The Health Savings Account (HSA) Distribution Form is designed to assist you in selecting an HSA distribution reason and method. Applicable law or policies of the HSA custodian/trustee may require additional documentation. A separate distributionform must be completed for each distributionreason. It is in your best interest to seek the
Purpose of Form. Use Form 720 and attachments to report your liability by IRS No. and pay the excise taxes listed on the form. If you report a liability on Part I or Part II, you may be eligible to use Schedule C to claim a credit.f you file the second quarter Form 720 only to report the patient-centered outcomes research fee, no filing is required in other quarters unless you have to report other fees or taxes. If you have adjustments to liabilities reported for prior quarters, see Form 720X, Amended Quarterly Federal Excise Tax Return.