Get Hsa Closure Request Form Mail Or Fax Completed Forms To: Address: Healthequity, Attn: Client

The HSA Closure Request Form is a crucial document for users looking to close their health savings account with HealthEquity. This guide provides clear instructions on how to effectively complete the form, ensuring a smooth closure process.

Follow the steps to successfully complete the HSA Closure Request Form.

1. Click ‘Get Form’ button to obtain the HSA Closure Request Form and open it in the editor.
2. Begin by filling out the 'Primary Account Holder Information' section. Ensure to include your last name, first name, street address, city, state, ZIP code, and email address. It is important to provide a valid daytime phone number for any follow-up communications.
3. In the 'SSN or HealthEquity ID Number' field, enter your Social Security Number or HealthEquity ID number, which consists of 6 or 7 digits.
4. Indicate the 'Reason for Account Closure' by selecting an option that best reflects your situation.
5. For the 'Authorization to Close' section, confirm your request to close the account by checking the appropriate box. You may choose to receive the remaining balance via electronic funds transfer (EFT) or a check to the verified address on file.
6. If selecting EFT transfer, include your financial institution details, routing number, and account number. Remember that a voided check or an actual check must be attached to this form.
7. Sign and print your name in the designated area and include the date to authorize the closure.
8. If you are transferring to another HSA custodian, fill out that section by providing the institution name, address, and signing as in Step 7. Note that EFT transfer is not supported for this option.
9. Review all completed sections for accuracy, ensuring no fields are left blank. Save your changes, then download, print, or share the completed form as needed.

Complete your HSA Closure Request Form online to ensure a seamless account closure process.