To open an HSA with Fidelity Bank, complete the following steps:
Complete the HSA Application, then mail the application and a copy of your government issued photo ID to:
Fidelity Bank
Attn: Deposit Services
100 E. English
Wichita, KS 67202
Once Fidelity Bank receives your application, we will complete the required account agreements and return them to you via US Mail.
After you have reviewed the terms of the account, sign the documents where indicated and return them, along with your opening contribution, to Fidelity Bank.
You will receive your pre-printed personal checks and your HSA Debit Card in the mail in approximately 10-14 days.
The forms listed above are in Adobe Acrobat PDF format.
If you do not have Adobe Acrobat Reader, you can click
here for your free download. Click this link for instructions
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