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Es of giving up my interest in this HSA, I have been advised to see a legal or tax professional. I hereby give the HSA holder any interest I have in the funds or property deposited in this HSA and consent to the beneficiary designation(s) indicated above. I assume full responsibility for any adverse consequences that may result. No tax or legal advice was given to me by the Custodian of my HSA. Spouse - Signature Required: 05/2012 CeB Date: Notary - Signature Required: Date: OVER 4 Signa.

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HSA Bank, a division of Webster Bank, N.A., empowers you to make the most of your healthcare dollars. Our vision is to inspire you to own your health by simplifying the health account experience and utilizing cutting edge technology and innovation to help you make sure you're on your way to a healthy financial future.

Access funds at an ATM, transfer funds to your bank account through the HSA online portal, or request a check from your HSA online.

You can withdraw funds from your HSA anytime. But keep in mind that if you use HSA funds for any reason other than to pay for a qualified medical expense, those funds will be taxed as ordinary income, and the IRS will impose a 20% penalty.

HSA Bank, a division of Webster Bank, N.A., delivers an industry-leading customer experience for employers and employees. We have built a reputation of world-class service and expertise through a focus on health accounts.

When can I withdraw money from my HSA? You can withdraw money at any time if it's used for qualified medical expenses. However, if you withdraw money for other purposes, your withdrawal will be subject to income tax (if the contribution was pre-tax) and a 20% penalty.

You can check your HSA balance by visiting the Member Website, where you will have secure, 24/7 access to your account balances and transaction history.

Your HSA is yours and yours alone. It is yours to keep, even if you resign, are terminated, retire from, or change your job. You keep your HSA and all the money in it, but keep in mind that there may be nominal bank fees if you are no longer enrolled in your HSA through your employer.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Bancorp Hsa
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