Get Hsa Application - With Hsa Resources

Filling out the HSA Application is a crucial step toward managing your health savings account efficiently. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and effectively.

Follow the steps to complete the HSA application online.

1. Press the ‘Get Form’ button to access the HSA Application and open it in your preferred editing tool.
2. Begin by filling out your personal information in the specified fields. This includes your full name, Social Security number, and date of birth. Ensure that your street address, city, state, and zip code are accurately entered.
3. If your mailing address differs from your street address, provide the necessary details in the mailing address section. Include the city, state, and zip code.
4. Enter your contact information, including both your home and work phone numbers, and your employer's name along with your occupation.
5. Attach a copy of your driver’s license as it is required for the application. Make sure to include your email address to participate in online banking services.
6. Complete the contribution information section by indicating your initial contribution amount. Be aware of the minimum requirement and contribute accordingly.
7. Choose the type of contribution you are making, either Regular, Rollover, or Transfer. Fill in the corresponding amounts as applicable.
8. If you wish to set up automated contributions from your checking account, indicate the amount and preferred day of the month for the withdrawal. Don't forget to attach a voided check for verification.
9. Sign the application confirming that you have read and agree to the terms outlined in the HSA Custodial Agreement. Be sure to date your signature.
10. After completing all sections, review your entries for accuracy. Then, save your changes, and you can choose to download, print, or share the form as needed.

Take the next step toward managing your health savings by completing the HSA Application online today.