MARICOPA
Limited Purpose FSA Card Expense Substantiation Form: Instructions How To Substantiate a Limited Purpose FSA Card Purchase To substantiate a card purchase, you will need to supply a receipt that clearly proves the eligibility of a purchase made using the Limited Purpose Flexible Spending Account (LPFSA) Card. For each card purchase that you have been asked to substantiate, you should: 1 COMPLETE FORM 1. 2. 3. Complete the LPFSA Expense Substantiation Form Attach itemized receipt(s) Submit the form MoreJan 1, 2011 ... in an Expense Substantiation Form and select the checkbox on the form indicating you do not have a receipt for the purchase. When a ... Less
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