APPLICATION AND ADOPTION AGREEMENT INSTRUCTIONSHealth Savings Account Application and Adoption Agreement • February 5th, 2010
Contract Type FiledFebruary 5th, 2010Thank you for your interest in opening a Health Savings Account at First American Bank. To establish your Health Savings Account ("HSA") you will need to complete this Application and Adoption Agreement (pages 3 and 4) and return them to us either by fax or by mail. Missing or incomplete information in the form you send may delay the opening of your account and may affect the deductibility of certain deposits.