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 or 529 plan to an existing PA ABLE Savings Program account.

ABLE TO WORK SELF CERTIFICATION FORM

Use this form to certify that you are eligible for an increased annual contribution limit as a result of your earned income.

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 update existing Account Owner information, transfer Account ownership to a new Account Owner, update existing Authorized Individual information, add or change an email address, change eligibility basis, add or update a Successor Account Owner, add or update a Successor Authorized Individual, or add or update an Interested Party.

PLEASE NOTE: Only a sibling of the current Account Owner may be named as a new Account Owner or a Successor 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.

Add an Authorized Individual Form

Use this form to add an Authorized Individual to an existing ABLE Account.

PLEASE NOTE: If you are adding an Authorized Individual for an adult Account Owner with the capacity to enter into contracts please use the Power of Attorney/Authorized Individual Form.

Power Of Attorney/Authorized Individual Form

Use this form to designate someone as an Authorized Individual with authority to act as your Agent on your PA ABLE Account.

W-9 Form

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