Eligiblity Quiz
Are you opening a PA ABLE Savings Program account for yourself or another person?
Yourself
Another Person
Are you an adult (18 or older) who is the intended beneficiary's parent, guardian, or power of attorney?
Yes
No
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Does the beneficiary have a qualified disability that began prior to the 26th birthday?
Yes
No
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Are you entitled to receive Supplemental Security Income (SSI
) or Social Security Disability Insurance (SSI
) because of your disability?
Yes
No
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Is the intended beneficiary entitled to receive Supplemental Security Income (SSI
) or Social Security Disability Insurance (SSI
) because of a disability?
Yes
No
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Has your condition lasted, or is it expected to last, more than 12 continuous months or result in death?
Yes
No
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Is the intended beneficiary legally blind OR have a severe physical or mental impairment?
Yes
No
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Has the intended beneficiary’s condition lasted, or is expected to last, more than 12 continuous months or result in death?
Yes
No
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You may be eligible. You must have a written diagnosis regarding your disability signed by a physician who meets SSA criteria. You must be able to provide it, if requested. You do not need to submit it with your enrollment form.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
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The intended beneficiary may be eligible. They must have a written diagnosis regarding your disability signed by a physician who meets SSA criteria. They must be able to provide it, if requested. They do not need to submit it with their enrollment form.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
Start OverYou may be eligible.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
Start OverThe intended beneficiary may be eligible.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
Start OverYou may not be eligible.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
Start OverThe intended beneficiary may not be eligible.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
Start OverYou may not be eligible.
Please call 855-529-ABLE (2253) with any additional questions or to talk with a customer service representative.
Start OverMy Account
Please Note: The PA ABLE Savings Program customer service call center will be closing at 2:00 p.m. on Friday, September 1, 2017, and will reopen at 8:00 a.m. on Tuesday, September 5, 2017.
My Account
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.
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 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.
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Phone: 855-529-ABLE (2253)Email: info@paable.gov
PA ABLE Savings Program
607 South Drive | Room 529
Harrisburg, PA 17120