Benchmark Bank HSA app 10 11

• All accounts receive a debit card for your qualified HSA distributions. Cash withdrawal at ATM machines from the HSA account is not allowed. • Approximately ten business days after we receive your application, you will receive a welcome letter and signature card from Benchmark Bank. It is important that you open this immediately and return the signature cards to the bank to activate your account. The debit card and PIN number will arrive separately approximately 10 - 14 days after the bank receives the signature card. Please fill out the HSA forms completely and provide all signatures requested. The following items must be enclosed to ensure timely processing of your account: Copy of driver’s license of each person who will be signing on the account (required by the Patriot Act) HSA account setup check in the amount of $25 made payable to: Benchmark Bank Opening HSA contribution: Benchmark Bank Return HSA forms and checks to: Benchmark Bank 5700 Legacy Drive Suite 10 Plano, TX 75024 Stacey Patton 972-673-4044 or Benchmark Bank 7019 Hillcrest Ave Dallas, TX 75205 Shannon Sims 972-673-4015 Your business is greatly appreciated. Please let us know if we can be of further service. Customer Identification Program IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial ...