Forms

Access your account online – or download these forms – to manage your PA ABLE Savings Program account.

Enrollment Guide

View a brief description of the PA ABLE Savings Program.

Disclosure Statement

View the complete Disclosure Statement for the PA ABLE Savings Program.

Enrollment Form

Use the enrollment form to open a PA ABLE Savings Program account.

Please note: You MUST read the Disclosure Statement and sign the Program Contract before opening an account.

Incoming Rollover Form

Use this form to request a direct rollover from another qualified ABLE plan to an existing PA ABLE Savings Program account.

Account Financial Features Form

Use this form to add, change, or delete a recurring contribution, Electronic Funds Transfer (EFT), Systematic Withdrawal Program (SWP), Systematic Exchange Program (SEP), and banking information on a PA ABLE Savings Program account.

Account Information Change Form

Use this form to change: name, mailing address, phone number, email address, Authorized Individual, or interested party information. You may also use this form to transfer assets to a new Account Owner.

Additional Contribution Form

Use this form to make additional contributions to a PA ABLE Savings Program account by check.

Payroll Direct Deposit Form

Use this form to start, change, or stop payroll direct deposit instructions to a PA ABLE Savings Program account.

Withdrawal Request Form

Use this form to make full or partial withdrawals from a PA ABLE Savings Program account.

Investment Option Change/Future Contribution Allocation Change Form

Use this form to request a twice per calendar year Investment Option change or to change the future contribution allocations.

Agent Authorization/Power of Attorney Form

Use this form to grant another person or organization authority to act on your PA ABLE account. You may choose one of four different levels of access, from the ability to receive account information to full authority over the account.

W-9 Form

Use this form to certify the account owner’s or authorized individual’s taxpayer identification number.

Business Continuity Plan

Use this form to certify the account owner’s or authorized individual’s taxpayer identification number.

Privacy Policy

Use this form to certify the account owner’s or authorized individual’s taxpayer identification number.

Link to the home page

Connect With Us

Phone: 855-529-ABLE (2253)
Email: info@paable.gov

 

PA ABLE Savings Program
607 South Drive | Room 529
Harrisburg, PA 17120