Get Payflex Hsa Trustee Transfer Form

Completing the Payflex Hsa Trustee Transfer Form online is a vital step in transferring your health savings account (HSA) funds to Payflex. This guide will assist you through each section of the form to ensure a seamless online experience.

Follow the steps to successfully complete the Payflex Hsa Trustee Transfer Form.

1. Click the ‘Get Form’ button to access the form and open it for editing.
2. In Section 1, fill out your personal details, including your first name, middle initial, last name, social security number, address, day-time telephone number, email address, and additional address details if necessary. Ensure your phone number is accessible for any follow-up by your current custodian or Payflex.
3. Proceed to Section 2, where you must choose the type of transfer that applies to you. Select only one option from the provided types: HSA to HSA transfer, Archer MSA to HSA transfer, or IRA to HSA transfer.
4. Complete Section 3 with the transfer instructions for the account you are moving to Payflex. Include the account number, name on the account, and the custodian’s name and address where applicable.
5. In Section 4, provide Payflex HSA information, including instructions for transferring the full account balance or a specified amount. Ensure all information is accurate.
6. Review all sections for accuracy, then sign and date the form in the ‘Certification and Signature’ section. Your signature signifies that you understand the tax implications and that all information is truthful.
7. After completing the form, you can save any changes, download, print, or share the form as needed.

Start filling out your Payflex Hsa Trustee Transfer Form online today to ensure a smooth transfer of your HSA funds.