Everence HSA Custodial AgreementEverence Hsa Custodial Agreement • October 7th, 2014
The account owner whose name appears on the Everence HSA application is establishing this HSA under Internal Revenue Code section 223 exclusively for the purpose of paying or reimbursing qualified medical expenses of the account owner, his or her spouse, and dependents. The account owner represents that, unless this account is used solely to make rollover or direct transfer contributions, he or she is eligible to contribute to this HSA. The account owner and Everence Federal Credit Union as the custodian make the following agreement:
