Account Closing Form - Avidia Health 2025

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Keep in mind, if you withdraw the remainder of your account when you close your HSA and dont roll over to another HSA or use the dollars for eligible medical expenses, you must report the withdrawals as income on your income tax return and you will owe a 20% additional tax penalty before age 65.
Your credit score is not directly affected by your checking and savings account activity. That includes account closures. Checking and savings accounts are not considered credit accounts. Credit accounts consist of lines of credit, such as credit cards, auto loans and mortgages.
Complete this form and email or mail to: HSA@avidiahealthcaresolutions.com or Avidia Bank, P.O. Box 161390 Altamonte Springs, FL 32716. Your remaining HSA balance will be mailed to you within three to five business days of Avidia Bank receiving this form.
Important Fee Information HSA Closure Fee $25.00 To avoid this fee, keep your account open with HSA Bank and continue to use your HSA funds for eligible expenses. 1 You may incur a lesser service fee than disclosed to you when your account has insufficient funds to cover the entire amount of the fee.
Format of Application for Closing Bank Account I am writing to request the closure of my bank account with the number (Account Number). I would like this account to be closed effective immediately. Please transfer any remaining balance to my new account at (New Bank Name and Account Details).
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