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RECURRING DEPENDENT CARE CONTRACT & CLAIM FORM Personal Information: (Please print) Employer Name: Request Date: Employee Name: Email Address: Employee SSN: Daytime Phone Number: Dependent Care Reimbursement
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How to fill out recurring dependent care contract

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How to fill out a recurring dependent care contract:

01
Gather necessary information: Start by collecting all relevant information, including the names of the parties involved (parent/guardian and caregiver), contact details, and the child's information such as name, age, and any specific needs or preferences.
02
Specify the terms and conditions: Clearly define the services to be provided, such as the days and hours of care, any specific activities or duties, and the payment structure. Outline any additional terms like late pick-up fees, sick child policy, or vacation time.
03
Include payment details: Specify the agreed-upon rate of pay per hour or per week/month, as well as the method of payment (e.g., cash, check, or electronic transfer). Outline any terms for late payments or bounced checks.
04
Communication and updates: Establish how the parent/guardian and caregiver will keep each other informed about the child's well-being, progress, or any issues that may arise. Specify the preferred method of communication, whether it's through text messages, phone calls, or in-person meetings.
05
Emergency procedures: Detail the steps to be followed in case of an emergency, including who to contact, medical information, and any necessary authorizations for the caregiver to seek medical attention on behalf of the child.
06
Termination and notice period: Include a section that outlines the conditions under which either party can terminate the contract and the required notice period. This can help avoid misunderstandings and ensure a smooth transition if either party needs to end the agreement.

Who needs a recurring dependent care contract?

Parents or guardians who regularly utilize the services of a caregiver for their dependent child. This contract is particularly relevant for families who require ongoing or long-term care arrangements, such as hiring a nanny, babysitter, or enrolling in a daycare program. Having a formal agreement in place helps set expectations, protects both parties, and ensures a clear understanding of the responsibilities and terms involved in the arrangement.
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A recurring dependent care contract is a formal agreement between an employee and a dependent care provider to provide ongoing care for dependents.
Employees who participate in a dependent care assistance program (DCAP) are required to file a recurring dependent care contract.
To fill out a recurring dependent care contract, employees need to provide information about the dependent care provider, the services provided, and the cost of the care.
The purpose of a recurring dependent care contract is to ensure that employees are using their DCAP funds for the care of qualified dependents.
Information such as the name and address of the dependent care provider, the amount paid for care, and the Social Security number of the provider must be reported on the recurring dependent care contract.
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