Special Account Forms

Download the form you desire by clicking the links below, then return by:

  • Bringing completed form into any Branch
  • Faxing it to our Call Center at (415) 674-4691.
  • Or mailing it to:
    SF Fire Credit Union
    3201 California Street
    San Francisco, CA 94118

The total annual contribution limit for 2015 is $3,350 for an individual and $6,650 for families. The catch up limit for 2015 is $1000 for both individual and family plans.

Health Savings Account: Application Packet Please fill out the this packet to open an HSA.

Health Savings Account: Beneficiary Designation or Change This form will allow you add, change or remove a beneficiary for your HSA account.

Health Savings Account: Change Notice This form will allow you to document changes to HSA owner information or account status.

Health Savings Account: Contribution and Investment Selection If you’d like to make a contribution to an HSA, use this form to designate which HSA product to place your funds.

Health Savings Account: Rollover Transfer Contributions Are you rolling or transferring your HSA from another institution or employer? Use this form to transfer or roll over funds.

Rollover indicates that you are bringing your HSA from one institution to another without needing a check in hand. Transferring indicates that the funds come from a financial institution in the form of a check that you are presenting.

Health Savings Account: Withdrawal Instructions Use this form to provide instruction on HSA withdrawals.