Instructions For Form Tc-675m Recipients

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Instructions for TC-675M Recipients
Attach PART B of the TC-675M to your Utah tax return to qualify for the deduction allowed under Section 59-10-114.
All recipients: The amount of money contributed to the MSA plan this year, plus plan earnings, should be claimed as a
deduction on your Utah tax return.
Non-medical distributions listed on lines 8 and 9 of this form, must be added to income on line 8 of your Utah tax return.
Penalty amounts withheld from distributions must be reported on the line provided on your Utah tax return. The amount on
line 9 reflects the non-medical distribution subject to the 10% penalty. The amount on line 12 is the total amount of penalties
withheld from non-medical distributions on line 9.
Follow the instructions in the Utah tax return booklet to correctly enter amounts on your Utah tax return.

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