Click below to complete your Transfer or Withdraw Forms.
Click here to download the Transfer form
Download the transfer form and mail it to your current provider. Then click next to end this session.
Click here to download the form
Download this form and then click Next to continue the withdraw process.
I certify that all the information provided by me is true and accurate. All decisions regarding this transfer are my own, and I expressly assume responsibility for any consequences that may arise from this transfer. I agree that the IAA Credit Union, current acting custodian, is not responsible for any consequences that may arise from processing this transfer authorization. I confirm that funds transferred out of my HSA will be subject to penalty if said funds are held within a certificate of deposit.
CONSENT TO THE USE OF ELECTRONIC RECORDS, SIGNATURES AND DISCLOSURES: Underlying law requires that you first consent to the use of electronic signatures and electronic records before you enter into this account agreement. Please (Click here to review this agreement) and read the information carefully.