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2017 HEALTH SAVINGS ACCOUNT (HSA)
CONTRIBUTION ELECTION AGREEMENT
This agreement is made between the employee and Penn State. Employee Name Penn State ID×Effective with the next available payroll,
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How to fill out contribution election agreement

How to fill out contribution election agreement
01
Obtain a contribution election agreement form from the relevant authority or organization.
02
Read the instructions carefully to understand the terms and conditions of the agreement.
03
Fill in your personal information such as name, address, contact details, and tax identification number.
04
Specify the contribution amount or percentage you would like to elect and indicate the frequency of your contributions (e.g., monthly, quarterly, annually).
05
If necessary, provide banking information or other payment details for the contributions.
06
Review the completed form to ensure all information is accurate and complete.
07
Sign and date the agreement.
08
Submit the filled-out contribution election agreement to the appropriate authority or organization, following any required procedures or submission guidelines.
Who needs contribution election agreement?
01
Contribution election agreement is typically needed by individuals or entities who wish to make regular contributions to a specific cause, organization, or fund.
02
Common examples include employees who want to contribute a portion of their salary to a retirement plan or charitable organization, investors who want to set up automatic contributions to mutual funds, or individuals who want to donate a fixed amount to an educational scholarship fund.
03
In summary, anyone who wants to establish a formal agreement to make regular contributions can benefit from a contribution election agreement.
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What is contribution election agreement?
Contribution election agreement is a document that allows an individual to specify how their contributions will be allocated among different candidates or committees.
Who is required to file contribution election agreement?
Any individual making contributions to multiple candidates or committees is required to file a contribution election agreement.
How to fill out contribution election agreement?
To fill out a contribution election agreement, an individual must specify the amount of money they want to contribute to each candidate or committee.
What is the purpose of contribution election agreement?
The purpose of contribution election agreement is to ensure that a donor's contributions are allocated according to their preferences among different candidates or committees.
What information must be reported on contribution election agreement?
The contribution election agreement must report the amount of money allocated to each candidate or committee, as well as the donor's personal information.
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