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DEPENDENT CARE REIMBURSEMENT ACCOUNT CLAIM FORM FLEXIBLE SPENDING ACCOUNT YOUR COMPANY NAME EMPLOYEE NAME: SSN: ADDRESS: SEND CLAIMS TO: Group Administrators, Ltd. Attn: FSA Administration 450 East
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A dependent care reimbursement account is a benefit provided by employers that allows employees to set aside a portion of their pre-tax income to pay for eligible dependent care expenses.
Employees who have eligible dependent care expenses and want to take advantage of the tax benefits offered by a dependent care reimbursement account are required to file.
To fill out a dependent care reimbursement account, employees need to provide their personal information, such as their name, address, and social security number, as well as the details of their dependent care expenses, including the name and address of the care provider and the amount paid.
The purpose of a dependent care reimbursement account is to help employees save money on eligible dependent care expenses by allowing them to use pre-tax dollars to pay for these expenses.
On a dependent care reimbursement account, employees must report their personal information, such as their name, address, and social security number, as well as the details of their dependent care expenses, including the name and address of the care provider and the amount paid.
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