Details
- Category
- Vendor
- Optum Financial
- Amount
- $1,787.60
- Date
- Jun 30, 2025
- Processed
- Feb 11, 2026 2:06 AM EST
- Original File
- Report_02112026_020533_000133.pdf
Summary
Quarterly Health Savings Account statement for Johan Jongsma showing an ending balance of $1,787.60 as of June 30, 2025, with $0.00 in year-to-date contributions and $9,550.00 remaining contribution limit.
Notes
No notes yet. Click Edit to add notes.
OCR Text
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## Page 1
**Optum Financialยฎ**
P.O. BOX 271629
SALT LAKE CITY, UT 84127-1629
Account number: 412231515
Statement dates: 04/01/2025-06/30/2025
0389581 SP 2104 -C01-P89890-
**JOHAN JONGSMA**
851 BRIGHTWATERS BLVD NE
SAINT PETERSBURG, FL 33704-3719
Thank you for being a HSA (health savings account) customer since 06/2018.
### Use your payment card to swipe and save
Use your payment card to swipe and save Save time-add your card to your phone's digital wallet. No paperwork hassle-no need for receipts. Shop your way: online, in-store, or from
### Your quarterly HSA statement at a glance
| | |
|:---|---:|
| **Beginning HSA cash balance as of 04/01/2025:** | $1,797.20 |
| **Ending HSA cash balance as of 06/30/2025:** | $1,787.60 |
**Your 2025 YTD contributions:**
**$0.00**
**$9,550**
Your 2025
contribution limit*
| $9,550.00 | Amount you can still contribute |
| $0.00 | Your YTD contribution |
*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.
### 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.
2104-01-b1-0389581-0001-0690811
---
## Page 2
### Optum Financialยฎ
**Account number:** 412231515
**Statement dates:** 04/01/2025-06/30/2025
### HSA cash transactions
| Date | Description | Withdrawals/Debits | Deposits/Credits |
|:---|:---|---:|---:|
| 04/30/2025 | Interest Payment | | $0.05 |
| 04/30/2025 | Monthly Maintenance Fee | -$2.75 | |
| 05/01/2025 | Printed Statement - Q1 2025 | -$1.50 | |
| 05/31/2025 | Interest Payment | | $0.05 |
| 05/31/2025 | Monthly Maintenance Fee | -$2.75 | |
| 06/30/2025 | Interest Payment | | $0.05 |
| 06/30/2025 | Monthly Maintenance Fee | -$2.75 | |
| **Total** | | **-$9.75** | **$0.15** |
2104-01-b1-0389581-0001-0890611
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