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Moore College Flexible Spending/Dependent Care Account 2015 Election Form Personal Information: Today's Date: / / Date of Hire: / / Last Name First Name Middle Initial Social Security Number Home
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How to Fill Out FSA Election Form-Moore 2011doc:
01
Start by obtaining a copy of the FSA Election Form-Moore 2011doc. This form can usually be obtained from your employer or the human resources department.
02
Read the instructions carefully before starting to fill out the form. The instructions will provide guidance on how to properly complete each section.
03
Begin by providing your personal information, such as your name, address, and Social Security number, in the designated fields on the form. Make sure to double-check the accuracy of this information.
04
Determine the type of flexible spending account (FSA) you are electing. This may include healthcare, dependent care, or a combination of both. Mark the appropriate box on the form to indicate your selection.
05
If you are electing a healthcare FSA, indicate the amount of money you wish to contribute from your salary to this account for the plan year. This amount is limited by IRS guidelines, so make sure you are aware of the maximum allowable contribution.
06
If you are electing a dependent care FSA, provide the amount of money you want to contribute to this account from your salary for the plan year.
07
If you have any questions or need assistance in completing the form, reach out to your employer or the human resources department for clarification.
08
Once you have filled out all the necessary sections of the form, review it for accuracy and completeness. Ensure that all required fields are filled and that your signature is provided where necessary.
09
Submit the completed form as instructed by your employer or the human resources department.
10
Keep a copy of the completed form for your records.
Who Needs FSA Election Form-Moore 2011doc?
01
Employees who have access to a flexible spending account (FSA) through their employer may need to fill out the FSA Election Form-Moore 2011doc.
02
Individuals who wish to contribute pre-tax dollars to a healthcare or dependent care FSA for the plan year will need to complete this form.
03
Those who want to take advantage of the tax benefits and reimbursement options provided by a FSA will typically be required to fill out this form by their employer.
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