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This document is a form for law firms to indicate their choice regarding the Health Savings Account (HSA) in connection with a High Deductible Health Plan for the 2013-2014 plan year.

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6. Review the completed form for any errors or omissions. Make sure that all required fields are filled before moving forward.
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8. Once you have reviewed and completed the form, print it out using a reliable printer. Ensure that the printed copy is clear and legible, as blurry or illegible printouts may result in delays or complications.
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