Get the free (HSA) Transfer Request Form - Windstream Benefits
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8772480510 8557176571 PO Box 6161 Fargo, ND 581086161 mercermarketplaceaccounts service account. Health Savings Account (HSA) Transfer Request Form Please complete this form fully and submit to the
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How to fill out hsa transfer request form
How to fill out hsa transfer request form
01
Obtain a copy of the HSA transfer request form from your current HSA custodian.
02
Fill out your personal information, including your name, address, and social security number.
03
Provide the details of your current HSA account, such as the account number and the name of the custodian.
04
Specify the desired transfer amount and indicate whether you want to transfer the entire balance or a partial amount.
05
Include the information of the receiving HSA custodian, including their name, address, and contact information.
06
Sign and date the form to authorize the transfer.
07
Submit the completed form to your current HSA custodian.
Who needs hsa transfer request form?
01
Anyone who wants to transfer their funds from one HSA account to another needs the HSA transfer request form. This could be individuals who switch jobs, change HSA custodians, or simply want to consolidate their HSA funds into a single account.
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