Two pages off our HSA and FSA Money Tracker, free: the cover page and the FSA balance ledger, as one US Letter PDF.

The ledger is one row per month, January to December, with grace and run-out rows underneath. Columns: in from pay, claimed this month, reimbursed, balance at month end, and what is still to spend before your deadline. Every cell is blank. We print no dollar limit, no percentage and no plan date, because those move by year, employer and carrier. The page points at the paper each figure comes from instead: your benefit notice, your administrator statement, your pay stub.

The other six pages (how-to-use habits, plan-year date card, burn-rate table, spend-down plan by member, claim log with an eligibility check, HSA contribution room) come in the full 8-page tracker, sold separately in A4 and US Letter.

Sample pages keep the tracker's own footers, so page 2 still reads "page 4 of 8". Print at actual size, black and white is fine. Personal and commercial use, reprint as often as you need. Ledger and worksheet only, not tax, medical or legal advice.