Form preview

Get the free HSA Closure request form

Get Form
Health Savings Account (HSA) Instructions for Account Closure Form To close your HSA, complete all the required sections of the enclosed form. If you have an HSA Investment Account, we will liquidate
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign hsa closure request form

Edit
Edit your hsa closure request form form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your hsa closure request form form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing hsa closure request form online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the services of a skilled PDF editor, follow these steps:
1
Log into your account. If you don't have a profile yet, click Start Free Trial and sign up for one.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit hsa closure request form. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.
Dealing with documents is always simple with pdfFiller. Try it right now

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out hsa closure request form

Illustration

How to fill out hsa closure request form

01
Obtain the HSA closure request form from your HSA provider.
02
Fill out your personal information such as name, address, and account number.
03
Indicate the reason for closing your HSA account.
04
Include any additional information or documentation required by your HSA provider.
05
Sign and date the form to certify the closure request.

Who needs hsa closure request form?

01
Individuals who no longer wish to have an HSA account and want to close it.
02
Individuals who are closing their existing HSA account and moving funds to another account.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.5
Satisfied
55 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

When you're ready to share your hsa closure request form, you can send it to other people and get the eSigned document back just as quickly. Share your PDF by email, fax, text message, or USPS mail. You can also notarize your PDF on the web. You don't have to leave your account to do this.
Completing and signing hsa closure request form online is easy with pdfFiller. It enables you to edit original PDF content, highlight, blackout, erase and type text anywhere on a page, legally eSign your form, and much more. Create your free account and manage professional documents on the web.
Add pdfFiller Google Chrome Extension to your web browser to start editing hsa closure request form and other documents directly from a Google search page. The service allows you to make changes in your documents when viewing them in Chrome. Create fillable documents and edit existing PDFs from any internet-connected device with pdfFiller.
The hsa closure request form is a document used to formally request the closure of a Health Savings Account (HSA).
Any individual who wishes to close their HSA account is required to file the hsa closure request form.
The hsa closure request form can be filled out by providing personal information, account details, and reasons for closure.
The purpose of the hsa closure request form is to officially close an HSA account and stop contributions and withdrawals.
The hsa closure request form typically requires personal information, account details, and reasons for closure.
Fill out your hsa closure request form online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.