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FIDELITY HSA CARD AGREEMENT AND DISCLOSURE STATEMENTNotice of Customer Rights and Liabilities Fidelity Brokerage Services LLC (Fidelity Brokerage) and National Financial Services LLC (NFS and together

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How to fill out fidelity hsa card agreement

01

Read through the fidelity HSA card agreement carefully to understand the terms and conditions.

02

Gather all the required information and documents such as your personal details, HSA account number, and any supporting documentation.

03

Start by filling out the personal details section of the agreement, including your name, address, and contact information.

04

Follow the instructions provided in each section of the agreement to provide the necessary information and signatures.

05

Pay special attention to any sections that require you to choose specific options or provide additional documentation.

06

Review the completed agreement thoroughly to ensure all the information provided is accurate and complete.

07

Sign and date the agreement where required.

08

Make a copy of the filled-out agreement for your records.

09

Send the completed agreement to the designated address or submit it online as per the instructions provided.

10

Keep a record of the submission for future reference.

Who needs fidelity hsa card agreement?

01

The fidelity HSA card agreement is needed by individuals who have a Health Savings Account (HSA) with Fidelity and wish to obtain a debit card for convenient access to their HSA funds.

02

Employers who offer Fidelity HSA plans to their employees may also need to ensure that their employees complete and sign the fidelity HSA card agreement if they choose to opt for the debit card option.

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What is fidelity hsa card agreement?

Fidelity HSA card agreement is a document outlining the terms and conditions for using a Health Savings Account (HSA) card provided by Fidelity.

Who is required to file fidelity hsa card agreement?

Individuals who have an HSA account with Fidelity and are issued an HSA card are required to file the agreement.

How to fill out fidelity hsa card agreement?

The fidelity HSA card agreement can be filled out by following the instructions provided by Fidelity either online or by mail.

What is the purpose of fidelity hsa card agreement?

The purpose of the fidelity HSA card agreement is to establish the terms and conditions for using the HSA card for eligible medical expenses.

What information must be reported on fidelity hsa card agreement?

The fidelity HSA card agreement typically requires personal information, card usage guidelines, and terms of service to be reported.

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