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HSA Request for Distribution Form

Complete this form to request a distribution from your Health Savings Account (HSA).

Unlike FSA claims, requests for HSA distributions do not require receipts; however you may want to store any associated receipts in the HSAToday ClaimsVault in case they are needed in the future.

HSAToday_Request_Distribution

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Dependent Care Recurring Expense Form
HSA Account Transfer Form
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