Interview Notes

$$ Rose Jones, age $57,$ is single.

$$ Rose earned wages of $$52,000$ and was enrolled the entire year in a high deductible health plan $($HDHP$)$ with self$-$only coverage.

$$ During the year, Rose contributed $$2,000$ to her Health Savings Account $($HSA$)$ and her mother also contributed $$1,000$ to Rose's HSA.

$$ Rose's Form W$-2$ shows $$850$ in Box $12$ with code W$.$ She has Form $5498-$SA showing $$3,850$ in Box $2.$

$$ Rose took a distribution from her HSA to pay her unreimbursed expenses:

o $8$ visits to a physical therapist after her knee surgery $$400$

o unreimbursed doctor bills for $$1,100$

o prescription medicine $$280$

o replacement of a crown $$1,500$

o deep cleaning for teeth: $$300$

o over the counter medication $$40$

o gym membership $$240$

$$ Rose is a U$.$S$.$ citizen with a valid Social Security number.

$6.$ Rose cannot include her mother's contribution on Form $8889,$ Part $1.$

a$.$ True

b$.$ False