FORM 8853: EDITING MULTIPLE SECTIONS AThis figure shows 3 partial Forms 8853.The bottom Form 8853 has a red X edited over the entire form and shows lines 1a through 5 with the following entries: The word Statement has been written across the top margin of the form by the taxpayer.Top line of Form 8853, Name(s) shown on return - Melinda Moose.Top line of Form 8853, Social security number of MSA account holder - 000-00-0077.Line 2, Archer MSA contributions you made for 2024, including those made from January 1, 2025 through April 15, 2025 that were for 2024. Do not include rollovers - 583.00.Line 3, Limitation from the Limitation Chart and Worksheet in the instructions - 300.00.The middle Form 8853 has a red X edited over the entire form and shows lines 1a through 6 with the following entries: The word Statement has been written across the top margin of the form by the taxpayer.Top line of Form 8853, Name(s) shown on return - Carl Moose.Top line of Form 8853, Social security number of MSA account holder - 000-00-1995.Line 2, Archer MSA contributions you made for 2024, including those made from January 1, 2025 through April 15, 2025 that were for 2024. Do not include rollovers - 400.00.Line 3, Limitation from the Limitation Chart and Worksheet in the instructions - 300.00.The top Form 8853 shows lines 1a through 6 with the following entries: Top line of Form 8853, Name(s) shown on return - Carl and Melinda Moose.Top line of Form 8853, Social security number of MSA account holder - 000-00-1995.Line 2, Archer MSA contributions you made for 2023, including those made from January 1, 2025 through April 15, 2025 that were for 2024. Do not include rollovers - 983.00.Line 3, Limitation from the Limitation Chart and Worksheet in the instructions - 600.00.Line 4 and Line 5 did not have any have entries written in by the taxpayer.