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Get the free CCS Flex Dollars Reimbursement Form

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This form is for students requesting a refund of their CCS Flex Dollars from their CCS SmART Card upon leaving CCS, subject to balance conditions and processing times.
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How to fill out CCS Flex Dollars Reimbursement Form

01
Obtain the CCS Flex Dollars Reimbursement Form from the appropriate website or office.
02
Fill out your personal information, including your name, employee ID, and contact details.
03
Specify the date and amount of the expenses being claimed.
04
Attach copies of receipts for each expense that is eligible for reimbursement.
05
Ensure all information is accurate and complete before submission.
06
Submit the completed form along with any necessary documentation to the designated office or department.

Who needs CCS Flex Dollars Reimbursement Form?

01
Employees who have incurred eligible expenses related to their flexibility benefits under the CCS program.
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The CCS Flex Dollars Reimbursement Form is a document that allows employees to request reimbursement for eligible expenses covered by their flex spending accounts.
Employees who have incurred eligible expenses covered under their flex spending accounts are required to file the CCS Flex Dollars Reimbursement Form to receive reimbursement.
To fill out the CCS Flex Dollars Reimbursement Form, provide personal details, specify the type of expense, attach any necessary receipts, and sign the form before submitting it to the appropriate department.
The purpose of the CCS Flex Dollars Reimbursement Form is to streamline the process for employees to receive reimbursements for qualified medical, dental, or dependent care expenses they have paid out-of-pocket.
The information that must be reported includes the employee's name, account number, date of service, amount spent, type of expense, and any supporting documentation, such as receipts.
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