Download a HSA Beneficiary Distribution Form

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Open, read, and print the appropriate document to send to Fidelity

HSA Beneficiary Distribution - Non-Spouse Beneficiary (PDF)

HSA Beneficiary Distribution - Estate, Trust, Entity, or Guardian/Conservator Beneficiary (PDF)

If you are unable to access these documents, you can have paper copies mailed to you by calling 800-343-3548.

To view the account's supporting documents, please return to the supporting documents page.

Questions?

This account is intended for U.S. residents only with a valid U.S. address. Non-U.S residents should visit our International Investment site.

Fidelity Investments is a registered trademark owned by FMR LLC. Accounts are carried with our affiliate, National Financial Services LLC, Member NYSE, SIPC, a member of the New York Stock Exchange and other principal exchanges. Fidelity Investments, P.O. Box 5000, Cincinnati, OH 45273-8669.

886065.1.0

Mutual Funds and Mutual Fund Investing - Fidelity Investments

Download & Complete the HSA Beneficiary Distribution Form

Open, read, and print the appropriate document to send to Fidelity

Questions?

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