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FLEXIBLE SPENDING ACCOUNT ENROLLMENT FORM Location Code: Company Group Number Employee Name (Last name first) Employee Soc. Sec. No. Address Payroll Schedule 24 pay periods per year 26 pay periods

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What is flex enrollment amp card?

Flex enrollment amp card is a form used for enrolling in a flexible spending account. It allows participants to set aside pre-tax dollars to pay for eligible medical expenses.

Who is required to file flex enrollment amp card?

Employees who wish to enroll in a flexible spending account are required to file a flex enrollment amp card.

How to fill out flex enrollment amp card?

To fill out the flex enrollment amp card, you need to provide personal information such as your name, employee ID, and contact details. You also need to indicate the desired contribution amount and select the types of expenses you plan to use the funds for.

What is the purpose of flex enrollment amp card?

The purpose of flex enrollment amp card is to allow individuals to allocate pre-tax funds for eligible medical expenses, helping to save on taxes and manage healthcare costs.

What information must be reported on flex enrollment amp card?

The flex enrollment amp card requires you to report your personal information, including name, employee ID, and contact details. You also need to indicate the desired contribution amount and specify the types of expenses you plan to use the funds for.

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