Eligiblity Quiz
Are you opening a PA ABLE Savings Program account for yourself or another person?
Yourself
Another Person
Who are you opening the account for?
An adult with legal
capacity to enter contracts
A minor child
An adult without legal
capacity to enter contracts Start Over
Are you an adult who is the intended beneficiary's power of attorney, legal guardian or conservator, spouse, parent, sibling, grandparent, or representative payee?
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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Based on your responses, it appears that you may be eligible to open a PA ABLE Savings Program account. However, you must have a written diagnosis signed by a physician who meets SSA criteria regarding your disability and you must be able to provide it, if requested. You will not need to submit it with your enrollment form.
Please call us at 855-529-2253 with any additional questions or to talk with a customer service representative.
Start Over
Based on your responses, it appears that that the intended beneficiary may be eligible to open a PA ABLE Savings Program account. However, he or she must have a written diagnosis signed by a physician who meets SSA criteria regarding his or her disability and must be able to provide it, if requested. You will not need to submit it with your enrollment form.
Please call us at 855-529-2253 with any additional questions or to talk with a customer service representative.
Start OverBased on your responses, it appears that you may be eligible to open a PA ABLE Savings Program account. Please call us at 855-529-2253 with any additional questions or to talk with a customer service representative.
Start OverBased on your responses, it appears that the intended beneficiary may be eligible to open a PA ABLE Savings Program account. Please call us at 855-529-2253 with any additional questions or to talk with a customer service representative.
Start OverBased on your responses, it appears that you may not be eligible to open a PA ABLE Savings Program account. Please call us at 855-529-2253 with any additional questions or to talk with a customer service representative.
Start OverBased on your responses, it appears that the intended beneficiary may not be eligible to open a PA ABLE Savings Program account. Please call us at 855-529-2253 with any additional questions or to talk with a customer service representative.
Start OverBased on your responses, it appears that you may not be eligible to open a PA ABLE Savings Program account for the intended beneficiary. Please call us at 855-529-2253 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 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.
Authorized Entity Signatory Form
Use this form if you are a company or organization serving as the Authorized Individual for one or more Eligible Individuals, to designate a representative or representatives to act on behalf of the Entity with respect to PA ABLE Accounts (“Signatories”).
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.
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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