Get Transfer/rollover Request Form - Hsa Bank

Filling out the Transfer/Rollover Request Form - HSA Bank is essential for moving funds to your HSA without complications. This guide provides clear instructions on how to complete the form online, ensuring a seamless transfer or rollover process.

Follow the steps to complete your transfer or rollover request.

1. Use the ‘Get Form’ button to access the Transfer/Rollover Request Form in your preferred digital document management system.
2. In Part 1, input your personal information which includes your first name, middle initial, last name, street address, city, state, zip code, social security number, and daytime phone number. Ensure accuracy to avoid processing delays.
3. In Part 2, indicate the type of request you are making. Choose 'Trustee to Trustee Transfer' if you are transferring funds directly from another trustee to HSA Bank. If you are doing a direct rollover with a check, select 'Direct MSA or HSA Rollover' and specify the check's amount.
4. Complete Part 3 with the current custodian's details, including their name, account number, address, city, state, zip code, and phone number. All fields in this section are mandatory unless you are mailing a rollover check with the form.
5. In Part 4, choose your transfer instructions. You can request a cash transfer, liquidate investments, or transfer investments in kind if applicable. If this is a partial transfer, specify the amount to be transferred while indicating that the account with your current organization should remain open.
6. Complete Part 5 by reviewing the account holder's authorization statement. Ensure you understand and accept the rules and conditions, and then provide your signature and the date.
7. Finally, review the entire form for completeness and accuracy. Save your changes, and you may choose to download, print, or share the completed form as needed.

Complete your Transfer/Rollover Request Form online today for a hassle-free experience.