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WITHDRAWAL AUTHORIZATION Refer to page 2 for reporting information. PART 2. HSA TRUSTEE OR CUSTODIANPART 1. HSA Owner be completed by the HSA trustee or custodian Social Security Number ___PO Box

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How to fill out 3314 hsa withdrawal authorization

01

Obtain the form 3314 HSA Withdrawal Authorization from your HSA provider.

02

Fill out your personal information such as name, address, and account number.

03

Indicate the amount you wish to withdraw from your HSA account.

04

Provide details on where the funds should be sent, such as a bank account number and routing number.

05

Sign and date the form, confirming your authorization for the withdrawal.

06

Submit the completed form to your HSA provider for processing.

Who needs 3314 hsa withdrawal authorization?

01

Individuals who have a Health Savings Account (HSA) and wish to make a withdrawal from their account.

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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.

Who is required to file 3314 hsa withdrawal authorization?

Individuals who wish to withdraw funds from their Health Savings Account are required to file 3314 HSA withdrawal authorization.

How to fill out 3314 hsa withdrawal authorization?

You can fill out 3314 HSA withdrawal authorization by providing the necessary information such as your account details, the amount you wish to withdraw, and any other required details.

What is the purpose of 3314 hsa withdrawal authorization?

The purpose of 3314 HSA withdrawal authorization is to authorize the withdrawal of funds from a Health Savings Account for qualified medical expenses.

What information must be reported on 3314 hsa withdrawal authorization?

On 3314 HSA withdrawal authorization, you must report your account details, the amount you wish to withdraw, and any other required information as per the form.

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