• July 30, 2019

Get the form # Description. HSA TRANSFER REQUEST HSA ACCOUNT OWNER’S NAME AND ADDRESS (Transferring HSA) CURRENT HSA. I authorize the transfer of the HSA assets in the manner described above and certify that all of the information provided by me is correct and may be relied upon . The Health Savings Transfer Request form is used to request the transfer of HSA funds at another financial institution to The HSA These instructions will assist you in completing the HSA Transfer Request form. If / H (Rev.

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In some embodiments, the search engine servers may query, e.

Next to each payee name, a list of accepted payment modes for the payee may be displayed. In some implementations, the device may extract any user-input offer generation restrictions e.

In one embodiment, the payee screen in the wallet mobile application user interface may facilitate user selection of one or more payees receiving the funds selected in the funds tab.

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For example, the pay network server may issue PHP commands to request the social network servers for social data. The virtual wallet application may compare the issuer-provided data to the data extracted from the QR code, Accordingly, the EOOR may calculate a revenue share for each of the websites in the user’s shopping trail using a revenue sharing model, and provide revenue sharing for the websites. In one implementation, the user may select the payee Jane P.

Based on the list of API templates, the pay network server may generate social data requests, e. The user may utilize tools available in the rule hss toolbox to design the rule according to the user’s desires. In some embodiments, merchant loyalty card information, gift card information, or products discount, coupon information may be accessible in a user wallet account, or via web.


Using the extracted fields and erquest values, the pay network server may generate a query, e. The card could be a loyalty card, which provides the user with a certain discount or rebate every time the user shops at the particular merchant, or the card could be a pre-paid gift card, allowing the user to purchase goods at the particular merchant’s website or physical store. For example, a consumer may tfansfer payment information, such as reques account number, bank routing number, user profile information, to an electronic wallet management consumer onboarding user interface, to associate an account with the electronic wallet.

If the user set the card selection preference as to maximize the overall dollar savings e. Based on the list of server addresses, the pay network server may generate transaction data requests, e. Pay server may then determine how to apply the discounts and allocate payment among various entities including merchants, manufacturers, retailers, and any other pertinent party.

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In one implementation, only the payment modes that are accepted by the payee may be selectable by the user. In a further implementation, the user may read the details of the offer by expanding the offer row as shown by in the user interface.

Each of the items in the receipt may then be examined to identify one or more items which could be charged to which payment device or account for tax or other benefits such as cash back, reward points, etc. The acquirer server may generate a card authorization request using the obtained card query request, and provide the card authorization request to a pay network server. The merchant server may optionally provide the generated card query request to an acquirer server. In some embodiments, a customer may register several cards with EOOR.


Using the electronic receipt, the user may exit the store with proof of purchase payment. Based on the type of modification requested by the user, the device may provide a graphical user interface GUI component see, e. Thus, the virtual wallet application may obtain the data encoded into the image, and may continue if the data can be processed by the virtual wallet application.

For example, the pay network server may periodically perform a search update of its aggregated search database, e.

HSA Forms Library

In some embodiments, the virtual wallet application may allow the user to zoom in to and out of the visualization, so rrquest the user may obtain a view with the appropriate amount of granularity as per the user’s desire see – The pay network server may issue the generated social data requests to the social networking services.

Then, the pay network server may generate a query for application programming interface API templates for the various search engines e.

User initiates Coupon Keeper by capturing an image of customer information. In embodiments where the user utilizes a plastic card instead of the user wallet device, the user may swipe the plastic card at the PoS client to transfer information from the plastic card into the PoS erquest, and then further to the Pay Network server.

For example, the user may modify settings such as, but not limited to: Based on the extracted data, the issuer server may generate a payment command, e. For example, the virtual wallet application executing on a user device may communicate with a server. A non-limiting, example listing of data that the EOOR hza return based on a query is provided below.