Account Closure Form - UMB Bank 2026

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  1. Click ‘Get Form’ to open the Account Closure Form in the editor.
  2. Begin by entering your UMB Health Savings Account number, which is a 10-digit number found on your HSA statement.
  3. In the 'Account Closure Request' section, select the reason for closing your account. You can choose from options such as permanent disability or no longer being covered by an HSA qualified plan.
  4. Provide your personal details including your name, address, phone numbers, and last four digits of your Social Security number.
  5. Sign and date the form to certify your request. Ensure all information is accurate before submission.
  6. Submit the completed form via mail, fax, or email as indicated at the bottom of the document.

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To close your HSA: Contact your HSA provider for information about the process. Fill out any required forms. Pay any closure fees. Make sure your HSA provider has updated contact information for you in case there are any questions.
Please note, all investment funds must be liquidated before the transfer is completed. 2.) Close your HSA and request the funds be distributed to you. To request your HSA be closed and the funds in the HSA distributed to you, log on to hsa.umb.com/individuals/forms, download and complete the HSA Closure Request form.
Its important to fill in all details accurately. Information Required: Typically, the form will ask for your account number, name, contact details, and sometimes the reason for account closure. Signature Requirement: Ensure that you provide your signature exactly as it appears on your ID.

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Fill Out the Account Closure Form: Complete the form provided by the bank representative. Be sure to double-check that all information is correct. Submit Your Request: Hand over the completed form and documents to the representative. They will process your request and may provide you with a confirmation receipt.

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