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Health Savings Account Employee Authorization Form for Payroll Deduction Use this form to start, change or stop payroll deductions for contributions to your Health Savings Account (HSA). You must
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You must be a tax form.
Anyone who meets the criteria set by the tax authorities.
You must fill out the form accurately and completely with all necessary information.
The purpose of the form is to report your income, deductions, and credits to determine your tax liability.
You must report your income, deductions, credits, and any other relevant information as required by the tax authorities.
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