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Cafeteria Plan Advisors, Inc. 420 Washington St. Suite 100 Braintree, MA 02184 Phone 781.848.9848 www.CPA125.com Fax 781.848.8477 AUTHORIZATION FOR PRE-TAX PAYROLL REDUCTION Form must be returned

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What is flexible spending enrollment form?

Flexible Spending Enrollment Form is a document that employees use to enroll in a Flexible Spending Account (FSA) offered by their employer. This account allows employees to set aside a portion of their pre-tax income to pay for eligible medical expenses throughout the year.

Who is required to file flexible spending enrollment form?

Employees who wish to participate in a Flexible Spending Account (FSA) are required to complete and file the flexible spending enrollment form with their employer.

How to fill out flexible spending enrollment form?

To fill out the flexible spending enrollment form, employees need to provide personal information such as name, address, and social security number. They will also need to select the amount of pre-tax income they want to allocate to their FSA and indicate the types of eligible expenses they intend to use the funds for.

What is the purpose of flexible spending enrollment form?

The purpose of the flexible spending enrollment form is to enroll employees in a Flexible Spending Account (FSA) and allow them to allocate a portion of their pre-tax income for eligible medical expenses, such as doctor visits, prescription medications, and medical supplies.

What information must be reported on flexible spending enrollment form?

The flexible spending enrollment form typically requires employees to provide their personal information, including their name, address, social security number, and employment details. They will also need to specify the amount of pre-tax income they want to contribute to their FSA and indicate the types of eligible expenses they plan to use the funds for.

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