HSA Contribution Form

Starting at: $25.00

The HSA Contribution form is used for regular and rollover contributions and to set up automatic HSA contributions. The form also sets forth the ability to return a “mistaken distribution.” Customization with your financial instituiton logo is available for an additional fee.

To see the complete set of HSA Legal Documents, click here.

Legal Documents Overview. The HSA legal documents package provides you the forms necessary to establish and administer HSAs as the HSA custodian. Our forms are the easiest in the industry for both you and your customers. The forms provide superior legal drafting with real world experience on top of the required compliance language offering you more liability protection and more usablity than other providers.

The Benefits include:
  1. Easy. The documents are all drafted in plain English and are easy to complete.
  2. Compliant. The documents are in compliance with federal HSA laws and regulations,
  3. Proven. HSA custodians have opened and managed thousands of HSAs using our documents.
See Sample Pages:
Page 1

Annual License. The HSA Legal Documents are sold under an annual license agreement that allows you to print copies, post to your website and email for one year. At the end of your term, you will have a renewal option. Annual renewal prices are the same as the first year, subject to inflationary increases. The license allows you to add your logo.

Complete HSA Website including all Worksheets, Legal Forms, Education and More! Click here for details.

Asset size < $250 Million=$25
Asset size < $250 Million w/logo=$99
Asset size $250-500 Million= $39
Asset size $250-500 Million w/logo= $129
Asset size Over $500 Million= $49
Asset size Over $500 Million w/logo= $149

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  • Manufactured by: HSA Authority

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This product was added to our catalog on Friday 07 November, 2008.

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