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Get UMB Health Savings Account Number

Ame MI Last Name Social Security Street Address (No Post Office Box) Phone (Day) PO Box, Apartment or Lot # City State ZIP B. Beneficiary Designation As the named Account Owner of the above-referenced Health Savings Account ( HSA ), I have the right to designate the beneficiary or beneficiaries to whom any funds remaining in my HSA upon my death are to be paid and, at any time and from time to time prior to my death, to revoke, alter or amend any such designation previously made. A.

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