Summary of Fees. Administrative Fee: $45 per year. Fee deducted from account balance. INTEREST SCHEDULE Health Savings Account (HSA)
Summary of Fees. (Section 3):
4.1 Base Fees $[**] monthly with [**]% [**] escalations on the [**] of the License Commencement Date. The first month fee payment is due upon execution of this License Agreement.
Summary of Fees. Administrative Fee: $45 per year. Fee deducted from account balance. INTEREST SCHEDULE Health Savings Account (HSA) Funding Your HSA Do not complete this form if you are making payroll deducted contributions through your employer. > Set up recurring contributions to your HSA (such as weekly or monthly) > Have contributions drafted from your personal bank account NOTE: This process can also be completed online after your account has been established. Attach a voided check here Health Savings Account (HSA)
Summary of Fees. Listed above is a summary of Fees under this Order. Once placed, your order shall be non-cancelable and the sums paid nonrefundable, except as provided in the Agreement.
Summary of Fees. (Complete Applicable Parts Only; Cross Through Inapplicable Parts.)
Summary of Fees. (Complete Applicable Parts Only; Cross Through Inapplicable Parts.) PART A-1 Rental Fees @ $ _= $ PART A-2 Rental Fees @ $ _= $ BALANCE: (To be paid no later than ) $
Summary of Fees. (List all charges for facilities, equipment, meals, and services below)
Summary of Fees. (Please see the Custodial Account Agreement for a full listing of fees.)
Summary of Fees. (Please see the Custodial Account Agreement for a full listing of fees.) Use this section to: Do not complete if you are making payroll deducted contributions through your employer. NOTE: This process can also be completed online after your account has been established. Contributions apply to the tax year in which they are credited to your account. In the future, if you wish to change the amount or stop automatic contributions you may log into your online account and submit the changes. Allow at least two business days to add, change or cancel any scheduled contributions. If your contribution is scheduled for a weekend or holiday, the bank will complete the transaction on the following business day. q Once q Weekly q Bi-weekly q Bi-Monthly - 1st and 15th of the Month q Monthly - 1st of the Month q Monthly - 15th of the Month q Monthly - Last Day of the Month q Quarterly - Last Day of the Quarter Contribution Amount $ Contribution Frequency: Start Date (mm|dd|yyyy) / / q End Date (mm|dd|yyyy) q Until notified to stop / / Account Nickname Name on Bank Account __ Bank Name Routing Number Account Number Account Type: q Checking q Savings Attach a voided check to this form. Starter checks, business checks, bank statements and deposit slips are not acceptable. If a check is not available, provide a letter from your bank on bank letterhead and signed by an authorized bank representative containing account information. Participant represents and warrants that he/she has received, read and is in agreement with all terms in the HSA Enrollment & Agreement, including the terms in the FPS Terms & Conditions, the HSA Custodial Account Agreement, FPS’s privacy policy, the summary of fees in Step 5 and any applicable addendums to the Participant Agreement, all of which are included in the HSA Enrollment & Agreement and/or are available at XxxxxxXxxxxxx.xxx, and which are incorporated by reference into this Participant Agreement. Participant agrees to be bound by the terms of the Participant Agreement (including the terms of incorporated documents), which may be changed, from time to time, upon notice from FPS Trust. Participant appoints FPS Trust Company, LLC (“FPS”) as custodian for the HSA established by the HSA Enrollment & Agreement and authorizes FPS (including its affiliates) to perform relevant custodial and administrative services. Participant acknowledges Health Savings Administrators (including its affiliates) as recordkeeper of the HSA established by the HSA En...
Summary of Fees. A Dartmouth Bikes rental costs $ plus a $ refundable deposit and must be paid with DASH funds at the time of bike pickup. The deposit will be returned to your DASH account following the return of your rental bike in the same or better condition than before. Renters who return damaged bikes will be responsible for the full cost of all repairs as assessed by a Dartmouth Bikes Mechanic, deducted first from the refundable deposit and then charged additionally thereafter. Renters who lose a combination lock belonging to Dartmouth Bikes will be charged a $20 replacement fee.
