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HEALTH SAVINGS ACCOUNT APPLICATION PART 1.HSA COUNTERPART 2.HSA CUSTODIAN To be completed by the HSA custodianName (First/MI/Last) Name Address Line 1 Address Line 1 Address Line 2 Address Line 2

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How to fill out this is an amendment

01

Start by reviewing the original document or agreement that the amendment is being made to.

02

Identify the specific sections or clauses that need to be amended.

03

Clearly state the changes or additions that should be made in the amendment.

04

Include any necessary legal language or references.

05

Make sure to clearly indicate which parts of the original document are being modified.

06

Include the effective date of the amendment, if applicable.

07

Sign and date the amendment, and have all parties involved in the original document sign and date as well.

08

Keep a copy of the original document and the signed amendment for future reference.

Who needs this is an amendment?

01

Anyone who wants to modify or update an existing agreement or document can use an amendment.

02

This could include individuals, businesses, organizations, or any other party involved in a legal agreement.

03

Amendments are commonly used in contracts, leases, legal agreements, and other similar documents.

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What is this is an amendment?

An amendment is a change or addition to a legal document.

Who is required to file this is an amendment?

The individual or entity making the change or addition is required to file an amendment.

How to fill out this is an amendment?

To fill out an amendment, you need to clearly state the changes or additions being made and provide any necessary supporting documentation.

What is the purpose of this is an amendment?

The purpose of an amendment is to update or correct information in a legal document.

What information must be reported on this is an amendment?

The specific information required to be reported on an amendment will depend on the type of legal document being amended.

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