Get Rollover/transfer Form - Wells Fargo - Eip Sc

Filling out the Rollover/Transfer Form for a Health Savings Account with Wells Fargo can be a straightforward process if you follow the right steps. This guide will provide you with detailed instructions to complete the form correctly and ensure your request is processed efficiently.

Follow the steps to complete the Rollover/Transfer Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out section A with your personal information, including your first name, last name, account number, social security number (last four digits), date of birth, phone number, alternate phone number, email, and employer name if applicable.
3. In section B, indicate whether you currently have a Wells Fargo HSA by selecting 'Yes' or 'No'. If you select 'No', be sure to complete the Individual Application for a Health Savings Account and submit it with your form.
4. In section C, select the type of account you are rolling over or transferring from. Indicate whether it is another HSA, Traditional IRA, Roth IRA, or Archer MSA, and specify whether you are transferring the full amount or a partial amount by providing the respective dollar amount.
5. In section D, specify whether you are requesting a rollover or transfer, and provide the necessary documents: either a personal check or money order if applicable, or a check from your former trustee/custodian.
6. Complete section E with the trustee/custodian information, including their name, address, and contact details.
7. In section F, review the tax implications outlined, then sign and date the form to acknowledge your understanding and acceptance of potential tax consequences.
8. Once all sections are complete, save your changes, then download, print, or share the form as needed, ensuring it is mailed to the correct address provided at the end of the document.

Complete your Rollover/Transfer Form online today to ensure timely processing of your request.