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WITHDRAWAL AUTHORIZATION Refer to page 2 for reporting information. PART 1.HSA COUNTERPART 2.HSA TRUSTEE OR CUSTODIANName (First/MI/Last) To be completed by the HSA trustee or custodian Utilities

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How to fill out 3314 hsa withdrawal authorization

01

To fill out Form 3314 HSA Withdrawal Authorization, follow these steps:

02

Start by entering your personal information, such as your name, Social Security number, and address.

03

Provide the name and address of your HSA custodian or trustee.

04

Indicate the type of withdrawal you are authorizing, whether it is a one-time withdrawal or a recurring withdrawal.

05

Specify the withdrawal amount and the frequency of the withdrawals if it is recurring.

06

If you have designated a beneficiary for your HSA, provide their information as well.

07

Sign and date the form to authorize the withdrawal.

08

Submit the completed form to your HSA custodian or trustee for processing.

Who needs 3314 hsa withdrawal authorization?

01

Anyone who has a Health Savings Account (HSA) and wishes to authorize a withdrawal from their account needs Form 3314 HSA Withdrawal Authorization. This form is necessary to initiate the withdrawal process and ensure the funds are distributed properly.

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What is 3314 hsa withdrawal authorization?

3314 hsa withdrawal authorization is a form used to authorize the withdrawal of funds from a Health Savings Account (HSA).

Who is required to file 3314 hsa withdrawal authorization?

Any individual who wants to withdraw funds from their HSA is required to file 3314 hsa withdrawal authorization.

How to fill out 3314 hsa withdrawal authorization?

To fill out 3314 hsa withdrawal authorization, you need to provide personal information, details of the HSA account, amount to be withdrawn, and signature.

What is the purpose of 3314 hsa withdrawal authorization?

The purpose of 3314 hsa withdrawal authorization is to authorize the withdrawal of funds from an HSA account for qualified medical expenses.

What information must be reported on 3314 hsa withdrawal authorization?

Information such as account holder's name, HSA account number, amount to be withdrawn, and purpose of withdrawal must be reported on 3314 hsa withdrawal authorization.

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