Details
- Category
- Vendor
- Optum Financial
- Amount
- $1,806.90
- Date
- 12/31/2024
- Processed
- Feb 16, 2026 4:09 AM EST
- Original File
- Report_02162026_040715_000231.pdf
Summary
Q4 2024 HSA statement for Johan Jongsma showing beginning balance of $1,816.59, ending balance of $1,806.90, with $0.00 YTD contributions and $9,300.00 remaining contribution capacity.
Notes
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OCR Text
---
## Page 1
Optum Financialยฎ
P.O. BOX 271629
SALT LAKE CITY, UT 84127-1629
**Account number:** 412231515
**Statement dates:** 10/01/2024-12/31/2024
0385500 SP 2103 -C01-P85805-
**JOHAN JONGSMA**
851 BRIGHTWATERS BLVD NE
SAINT PETERSBURG, FL 33704-3719
---
Thank you for being a health savings account (HSA) customer since **06/2018**.
### Coming soon: Your tax documents
Your 2024 tax forms will be available by the end of January. You'll be notified based on your communication preference, or you may sign in to your account online to download them.
---
### Your quarterly HSA statement at a glance
| | |
|:---|---:|
| **Beginning HSA cash balance as of 10/01/2024:** | $1,816.59 |
| **Ending HSA cash balance as of 12/31/2024:** | $1,806.90 |
**Your 2024 YTD contributions:**
**$0.00**
---
$9,300
**Your 2024 contribution limit***
| | |
|:---|---:|
| **$9,300.00** | Amount you can still contribute |
| **$0.00** | Your YTD contribution |
---
### Helpful tips
**Contribute**
Leading financial advisors consider HSAs one of the most powerful savings accounts due to it's pre-tax savings and unlike a 401k, you can access and use your HSA for eligible expenses at any time before retirement age.
**Invest**
Take your HSA beyond medical cost savings. You may be able to use it as a smart investment option that can help you build a financial plan for today and tomorrow.
---
\*Your contribution amount can vary based on your Plan elections, eligibility and other factors. Please consult your legal, accounting or tax advisor to determine the amount applicable to your situation.
---
## Page 2
Optum Financialยฎ
**Account number:** 412231515
**Statement dates:** 10/01/2024-12/31/2024
### HSA cash transactions
| Date | Description | Withdrawals/Debits | Deposits/Credits |
|------|-------------|-------------------|------------------|
| 10/31/2024 | Interest Payment | | $0.02 |
| 10/31/2024 | Monthly Maintenance Fee | -$2.75 | |
| 11/13/2024 | Printed Statement - Q3 2024 | -$1.50 | |
| 11/30/2024 | Interest Payment | | $0.02 |
| 11/30/2024 | Monthly Maintenance Fee | -$2.75 | |
| 12/31/2024 | Interest Payment | | $0.02 |
| 12/31/2024 | Monthly Maintenance Fee | -$2.75 | |
| **Total** | | **-$9.75** | **$0.06** |
2103-01-b1-03858500-0001-05944486
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