Get Form 1239

Filling out Form 1239 online is a straightforward process that ensures necessary bank account information is accurately collected for medical assistance eligibility. This guide provides clear, user-friendly steps to complete the form effectively.

Follow the steps to accurately complete Form 1239 online.

1. Click 'Get Form' button to access the form and open it in the designated editor.
2. In the first section, enter the name of the depositor exactly as it appears on the bank account. Ensure you use proper capitalization for clarity.
3. Next, input the account number associated with the depositor. Double-check the number for accuracy to prevent delays.
4. Provide any additional comments that may be relevant, particularly about other accounts related to the individual, such as IRAs, CDs, and safe deposit boxes.
5. On the designated dates, make sure to provide account balances as of the close of business. This includes checking for the most accurate information.
6. At the bottom of the first page, the responsible staff member should include their signature, telephone number, and the date of completion.
7. If applicable, specify if any accounts have been closed and provide the necessary closing account details.
8. Once all information is accurately filled out, you can save changes, download, print, or share the completed form as required.

Complete your documents online today for a seamless processing experience.