Common use of Account Owner’s Representations and Responsibilities Clause in Contracts

Account Owner’s Representations and Responsibilities. The Account Owner represents that all information that the Account Owner has provided or will provide to the Custodian under this Agreement is complete and accurate and the Custodian may rely upon it. The Account Owner will comply with all legal requirements governing this Agreement and the HSA and assumes all responsibility for his or her actions including, but not limited to, eligibility determination, contributions, distributions, penalty infractions, proper filing of tax returns and compliance with the Internal Revenue Code and other applicable law in connection with this Agreement. Subject to the policies and practices of the Custodian, the Account Owner may delegate certain responsibilities by appointing an Authorized Agent in writing in a form and manner acceptable to the Custodian. Upon receipt of a designation of an Authorized Agent by the Account Owner in a form acceptable to the Custodian, the Custodian may fully rely on Instructions from the Authorized Agent as if the Custodian had received the Instructions from the Account Owner. The Account Owner will pay the Custodian reasonable compensation for its services, as disclosed in the applicable fee schedules, as amended from time to time. The Account Owner is responsible for determining the suitability of the High Deductible Health Plan associated with this HSA. The Account Owner agrees to indemnify and hold the Custodian harmless from any adverse consequences or losses incurred based on the representations, statements, actions or inactions of the insurance company or agent that sold the Account Owner the HDHP associated with this HSA. The insurance agent or agency is not the Custodian’s partner, agent, affiliate, representative or co-venturer. Account Owner shall have a password that will allow Account Owner access to his/ her HSA online. It shall be Account Owner’s sole responsibility to keep the password private. Account Owner shall be responsible for all actions taken by any person using Account Owner’s password, whether or not such use was authorized by Account Owner. In the event that Account Owner has provided an electronic signature to Custodian in connection with an account application or other click sign agreement, Account Owner agrees Custodian may rely on such electronic signature for purposes of Account Owner’s authorization of withdrawals or third- party transfers, notices to change of name or address, or other instructions to Custodian. Custodian shall not be required to obtain Account Owner’s physical signature for such purposes or any other purpose, except as may be required by law.

Account Owner’s Representations and Responsibilities. The Account Owner represents that all information that the Account Owner has provided or will provide to the Custodian under this Agreement is complete and accurate and the Custodian may rely upon it. The Account Owner will comply with all legal requirements governing this Agreement and the HSA and assumes all responsibility for his or her actions including, but not limited to, eligibility determination, contributions, distributions, penalty infractions, proper filing of tax returns and compliance with the Internal Revenue Code and other applicable law in connection with this Agreement. Subject to the policies and practices of the Custodian, the Account Owner may delegate certain responsibilities by appointing an Authorized Agent in writing in a form and manner acceptable to the Custodian. Upon receipt of a designation of an Authorized Agent by Instructions from the Account Owner in a form acceptable to and proof of acceptance by the CustodianAuthorized Agent, the Custodian may fully rely on Instructions from the Authorized Agent as if the Custodian had received the Instructions from the Account Owner. The Account Owner will pay the Custodian reasonable compensation for its services, as disclosed in the applicable fee schedules, as amended from time to time. The Account Owner is responsible for determining the suitability of the High Deductible Health Plan associated with this HSA. The Account Owner agrees to indemnify and hold the Custodian harmless from any adverse consequences or losses incurred based on the representations, statements, actions or inactions of the insurance company or agent that sold the Account Owner the HDHP associated with this HSA. The insurance agent or agency is not the Custodian’s partner, agent, affiliate, representative or co-venturer. Account Owner shall have a password that will allow Account Owner access to his/ her HSA online. It shall be Account Owner’s sole responsibility to keep the password private. Account Owner shall be responsible for all actions taken by any person using Account Owner’s password, whether or not such use was authorized by Account Owner. In the event that Account Owner has provided an electronic signature to Custodian in connection with an account application or other click sign agreement, Account Owner agrees Custodian may rely on such electronic signature for purposes of Account Owner’s authorization of withdrawals or third- party transfers, notices to change of name or address, or other instructions to Custodian. Custodian shall not be required to obtain Account Owner’s physical signature for such purposes or any other purpose, except as may be required by law.

Account Owner’s Representations and Responsibilities. The Account Owner represents that all information that the Account Owner has provided or will provide to the Custodian under this Agreement is complete and accurate and the Custodian may rely upon it. The Account Owner will comply with all legal requirements governing this Agreement and the HSA and assumes all responsibility for his or her actions including, but not limited to, eligibility determination, contributions, distributions, penalty infractions, proper filing of tax returns and compliance with the Internal Revenue Code and other applicable law in connection with this Agreement. Subject to the policies and practices of the Custodian, the Account Owner may delegate certain responsibilities by appointing an Authorized Agent in writing in a form and manner acceptable to the Custodian. Upon receipt of a designation of an Authorized Agent by Instructions from the Account Owner in a form acceptable to and proof of acceptance by the CustodianAuthorized Agent, the Custodian may fully rely on Instructions from the Authorized Agent as if the Custodian had received the Instructions from the Account Owner. The Account Owner will pay the Custodian reasonable compensation for its services, as disclosed in the applicable fee schedules, as amended from time to time. The Account Owner is responsible for determining the suitability of the High Deductible Health Plan associated with this HSA. The Account Owner agrees to indemnify and hold the Custodian harmless from any adverse consequences or losses incurred based on the representations, statements, actions or inactions of the insurance company or agent that sold the Account Owner the HDHP associated with this HSA. The insurance agent or agency is not the Custodian’s partner, agent, affiliate, representative or co-venturer. Account Owner shall have a password that will allow Account Owner access to his/ her HSA online. It shall be Account Owner’s sole responsibility to keep the password private. Account Owner shall be responsible for all actions taken by any person using Account Owner’s password, whether or not such use was authorized by Account Owner. In the event that Account Owner has provided an electronic signature to Custodian in connection with an account application or other click sign agreement, Account Owner agrees Custodian may rely on such electronic signature for purposes of Account Owner’s authorization of withdrawals or third- third-party transfers, notices to change of name or address, or other instructions to Custodian. Custodian shall not be required to obtain Account Owner’s physical signature for such purposes or any other purpose, except as may be required by law.

Account Owner’s Representations and Responsibilities. The Account Owner represents that all information that the Account Owner has provided or will provide to the Custodian under this Agreement is complete and accurate and the Custodian may rely upon it. The Account Owner will comply with all legal requirements governing this Agreement and the HSA and assumes all responsibility for his or her actions including, but not limited to, eligibility determination, contributions, distributions, penalty infractions, proper filing of tax returns and compliance with the Internal Revenue Code and other applicable law in connection with this Agreement. Subject to the policies and practices of the Custodian, the Account Owner may delegate certain responsibilities by appointing an Authorized Agent in writing in a form and manner acceptable to the Custodian. Upon receipt of a designation of an Authorized Agent by the Account Owner in a form acceptable to the Custodian, the Custodian may fully rely on Instructions from the Authorized Agent as if the Custodian had received the Instructions from the Account Owner. The Account Owner will pay the Custodian reasonable compensation for its services, as disclosed in the applicable fee schedules, as amended from time to time. The Account Owner is responsible for determining the suitability of the High Deductible Health Plan associated with this HSA. The Account Owner agrees to indemnify and hold the Custodian harmless from any adverse consequences or losses incurred based on the representations, statements, actions or inactions of the insurance company or agent that sold the Account Owner the HDHP associated with this HSA. The insurance agent or agency is not the Custodian’s partner, agent, affiliate, representative or co-venturer. Account Owner shall have a password that will allow Account Owner access to his/ her HSA online. It shall be Account Owner’s sole responsibility to keep the password private. Account Owner shall be responsible for all actions taken by any person using Account Owner’s password, whether or not such use was authorized by Account Owner. In the event that Account Owner has provided an electronic signature to Custodian in connection with an account application or other click sign agreement, Account Owner agrees Custodian may rely on such electronic signature for purposes of Account Owner’s authorization of withdrawals or third- third-party transfers, notices to change of name or address, or other instructions to Custodian. Custodian shall not be required to obtain Account Owner’s physical signature for such purposes or any other purpose, except as may be required by law.

Account Owner’s Representations and Responsibilities. The Account Owner represents that all information that the Account Owner has provided or will provide to the Custodian under this Agreement is complete and accurate and the Custodian may rely upon it. The Account Owner will comply with all legal requirements governing govern- ing this Agreement and the HSA and assumes all responsibility for his or her actions including, but not limited to, eligibility determination, contributions, distributions, penalty infractions, proper filing of tax returns and compliance with the Internal Revenue Reve- nue Code and other applicable law in connection with this Agreement. Subject to the policies and practices of the Custodian, the Account Owner may delegate certain responsibilities by appointing an Authorized Agent in writing in a form and manner acceptable to the Custodian. Upon receipt of a designation of an Authorized Agent by Instructions from the Account Owner in a form acceptable to and proof of acceptance by the CustodianAuthorized Agent, the Custodian may fully rely on Instructions from the Authorized Agent as if the Custodian had received the Instructions from the Account Owner. The Account Owner will pay the Custodian reasonable compensation for its services, as disclosed in the applicable fee schedules, as amended from time to time. The Account Owner is responsible for determining the suitability of the High Deductible Health Plan associated with this HSA. The Account Owner agrees to indemnify and hold the Custodian harmless from any adverse consequences or losses incurred based on the representations, statements, actions or inactions of the insurance company com- pany or agent that sold the Account Owner the HDHP associated with this HSA. The insurance agent or agency is not the Custodian’s partner, agent, affiliate, representative representa- tive or co-venturer. Account Owner shall have a password that will allow Account Owner access to his/ her HSA online. It shall be Account Owner’s sole responsibility to keep the password private. Account Owner shall be responsible for all actions taken by any person using Account Owner’s password, whether or not such use was authorized by Account Owner. In the event that Account Owner has provided an electronic signature to Custodian in connection with an account application or other click sign agreement, Account Owner agrees Custodian may rely on such electronic signature for purposes of Account Owner’s authorization of withdrawals or third- third-party transfers, notices to change of name or address, or other instructions to Custodian. Custodian shall not be required to obtain Account Owner’s physical signature for such purposes or any other purpose, except as may be required by law.