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HSA Custodial Booklet set Form # 40-HSA Revised 5/08 
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HSA Custodial Booklet Set

Purpose of Form: Form 5305-C is a model custodial account agreement that has been approved by the IRS. An HSA is established after the form is fully executed by both the account owner and the custodian. The form can be completed at any time during the tax year.This account must be created in theUnited States for the exclusive benefit of the account owner.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 25 forms. Call for quantity pricing or for imprint orders.



HSA Trust Booklet set Form # 41-HSA Revised 5/08 
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HSA Trust Booklet Set

Purpose of Form: Form 5305-B is a model trust account agreement that has been approved by the IRS. An HSA is established after the form is fully executed by both the accountowner and the trustee. The form can be completed at any time during the tax year. This account must be created in theUnited States for the exclusive benefit of the account owner.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 25 forms. Call for quantity pricing or for imprint orders.



HSA Custodial Self-Directed Booklet set Form # 42-HSA Revised 5/08 
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HSA Custodial Self-Directed Booklet Set

Purpose of Form: Form 5305-C is a model custodial account agreement that has been approved by the IRS. An HSA is established after the form is fully executed by both the account owner and the custodian.The form can be completed at any time during the tax year. This account must be created in the United States for the exclusive benefit of the account owner.

This form can be imprinted. Call 800-346-3961 for details.

Package contains 25 forms. Call for quantity pricing or for imprint orders.



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