Health Savings Accounts Forms
HSA Beneficiary Designation Form
Identify who should receive your HSA assets in the event of your death.
HSA Contribution Form
Make a normal, mistaken distribution, or rollover contribution to your HSA.
HSA Death Distribution Request Form
Use to authorize a distribution of assets from a decedent’s HSA.
HSA Decedent Claim Direct Deposit Form
Request a onetime disbursement of funds from an Associated Bank HSA to another deposit account via electronic ACH transfer relating to a decedent claim.
HSA Distribution Request Form
Request a distribution from your HSA.
HSA Individual Transfer Form
Use to initiate a direct transfer of funds from your current HSA.
HSA Legal Name Change Form
Use to make a legal name change on your HSA.