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REQUEST FOR REIMBURSEMENT PLEASE FAX this signed and completed form to: (877) FLEX-CLM (877-353-9256) For Customer Service, please call: (877) FLEX-IVR (877-353-9487) 1. Participant Information and
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BAFBLACB flex form is a form used for reporting flexible spending account contributions and withdrawals.
Employees who contribute to a flexible spending account are required to file baflacb flex form.
To fill out baflacb flex form, you need to provide information about your contributions and withdrawals from your flexible spending account.
The purpose of baflacb flex form is to report contributions and withdrawals from flexible spending accounts.
You must report your contributions and withdrawals from your flexible spending account on baflacb flex form.
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