Get Hsa Closure Request Form - Healthequity

Closing your health savings account (HSA) with HealthEquity is a straightforward process. This guide provides clear instructions on how to complete the HSA Closure Request Form online, ensuring you have all necessary information at hand.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to access the HSA Closure Request Form and open it in your preferred document editor.
2. Complete the 'Primary Account Holder Information' section. Provide your last name, first name, street address, city, state, ZIP code, email address, daytime phone number, and the last four digits of your Social Security number or HealthEquity ID number.
3. Indicate the reason for account closure in the designated field. If the closure is due to the death of the account holder, attach a copy of the death certificate.
4. In the ‘Authorization to Close’ section, select your preference for receiving the remaining balance. If you wish to receive funds via electronic funds transfer (EFT), check the appropriate box. Remember that EFT is not available if the account is closed due to death.
5. Fill in the financial institution's details if you select the EFT option. Provide the routing number and account number, ensuring this is accompanied by either a voided check or an actual check.
6. Sign and date the form. It is important to complete this step for your request to be processed.
7. Once all sections are completed, save your changes, download the form, and print it or share it as necessary. Mail or fax the completed form to HealthEquity at the specified address.

Ensure your HSA Closure Request Form is completed accurately by following these steps carefully.