Account Holder Forms

Enrollment Form. Complete this form to open your First Horizon HSA, or click here to enroll online.

Mail-In Deposit Form. Use this form when you wish to mail in a check to make a contribution to your HSA.

Request to Transfer Form. Use this form to transfer your existing HSA from another financial institution to First Horizon Msaver.

Distribution Form. Use this form to request any types of special distributions from your HSA. These include removal of an excess contribution, or distributions due to prohibited transactions, transfers to spouse, death, disability, or revocation.

Request to Rollover Form. Use this form when you wish to make a rollover contribution to your First Horizon HSA. Be sure to include this form with your contribution check to ensure that funds are coded properly for tax purposes.

Designation or Change of Beneficiary Form. Use this form to designate or change beneficiaries on your HSA.

Add or Remove Authorized Signers Form. Use this form if you wish to add or remove authorized signers to or from your HSA.

ACH Authorization Form. Use this form to set up automatic ACH transactions on your HSA.

IRA to HSA Transfer Form. Use this form to transfer funds from an IRA to your HSA. However, the amount you transfer to your HSA is subject to the annual contribution limits.