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HSA Deduction Authorization I am currently enrolled in TLC Homes High Deductible HSA Qualified Health Plan. I authorize the following biweekly payroll deduction to be directly deposited in my Health
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How to fill out hsa deduction authorization 2016doc
How to fill out HSA deduction authorization 2016doc:
01
Obtain the HSA deduction authorization 2016doc form.
02
Fill out your personal information, including your name, address, and social security number.
03
Provide your employer's information, including their name and address.
04
Indicate the amount you would like to contribute to your HSA for the year 2016.
05
Sign and date the form to certify your authorization.
06
Make a copy of the completed form for your records.
07
Submit the form to your employer or the appropriate department as instructed.
Who needs HSA deduction authorization 2016doc:
01
Employees who have a Health Savings Account (HSA) and wish to authorize deductions from their salary or wages to contribute to their HSA for the year 2016.
02
Employers who offer HSA plans to their employees and need the authorization form filled out in order to process the deductions.
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