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8777658815 8776689598 PO Box 784 Fargo, ND 581070784 individualhsa@wexhealth.comIndividual Health Savings Account (HSA) Distribution Request/Account Closure Form Use this form to request a distribution
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Download the wexhsa-distribution-request-account-closure-formpdf from the official website.
02
Fill out all the required fields on the form, including your personal information and account details.
03
Sign the form at the designated section to authorize the closure of the account.
04
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05
Submit the completed form to the appropriate department or contact person as specified in the form.

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Individuals who wish to close their wexhsa account and withdraw their funds or assets.
02
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wexhsa-distribution-request-account-closure-formpdf is a form used to request the closure of an account within the Wexhsa system.
Any individual or entity who wishes to close their account within the Wexhsa system is required to file the wexhsa-distribution-request-account-closure-formpdf form.
The wexhsa-distribution-request-account-closure-formpdf form can be filled out electronically or manually, following the instructions provided on the form itself.
The purpose of wexhsa-distribution-request-account-closure-formpdf is to formally request the closure of an account within the Wexhsa system.
The wexhsa-distribution-request-account-closure-formpdf form typically requires information such as account details, reason for closure, and any additional documentation requested by the form.
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