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PROGRESSIVE BENEFIT SOLUTIONS LLC Request for Reimbursement FSA/DCA CLAIM FORM 10/2011 Employer Name Employee Name Address Last First MI Street City State SS Zip Phone Please check if this is a new address Information below must be completed MEDICAL EXPENSE CLAIMS Please read the Reimbursement Account Rules and Claim Filing Instructions before completing this claim. For Direct Deposit see attached instructions Date of Service MM/DD/YY Patient Nam...

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What is carbon lehigh imtermediate unit?

The Carbon Lehigh Intermediate Unit is an educational service agency that provides support and resources to school districts in Carbon and Lehigh counties in Pennsylvania.

Who is required to file carbon lehigh imtermediate unit?

School districts in Carbon and Lehigh counties in Pennsylvania are required to file with the Carbon Lehigh Intermediate Unit.

How to fill out carbon lehigh imtermediate unit?

To fill out the Carbon Lehigh Intermediate Unit, school districts need to provide information about their educational programs, budgets, and student enrollment.

What is the purpose of carbon lehigh imtermediate unit?

The purpose of the Carbon Lehigh Intermediate Unit is to provide support and services to school districts, including special education programs, professional development for teachers, and administrative resources.

What information must be reported on carbon lehigh imtermediate unit?

School districts must report information such as their budget, student enrollment, and educational programs on the Carbon Lehigh Intermediate Unit.

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