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ELMS COLLEGE Dependent Care Account Reimbursement Request Form Plan Year: 7/1/2011 6/30/2012 Employee Name: Address (Street, City, State, Zip): Submit Claims To: BFP Associates PO Box 478 West Springfield,
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How to fill out elms-dependent care reimbursement form-2011-12pdf:

01
Start by downloading the elms-dependent care reimbursement form-2011-12pdf from the official website or the source where it is available.
02
Open the downloaded form using a PDF reader or editing tool that allows you to input information.
03
Begin by providing your personal information accurately in the designated fields. This typically includes your name, address, social security number, and contact details.
04
Next, carefully read the instructions provided on the form to understand the eligibility criteria and requirements for reimbursement. This will help ensure that you fill out the form correctly.
05
Fill in the details of your dependent for whom you are seeking reimbursement. Include their full name, date of birth, relationship to you, and any other relevant information as requested.
06
Specify the type of dependent care that you are seeking reimbursement for. This could include expenses related to daycare centers, in-home care providers, or after-school programs.
07
Enter the total amount spent on dependent care during the specified period (2011-12, in this case) and provide any supporting documentation such as receipts or invoices.
08
If you have received any reimbursements or payments from other sources for dependent care expenses, disclose this information accurately.
09
Double-check all the information filled in the form to ensure accuracy and completeness.
10
Once you are satisfied with the information provided, save the filled form as a new document to retain a copy for your records.
11
Submit the completed elms-dependent care reimbursement form-2011-12pdf to the relevant authority or organization responsible for processing reimbursements.

Who needs elms-dependent care reimbursement form-2011-12pdf:

01
Employees or individuals who have dependent care expenses and are eligible for reimbursement.
02
Anyone seeking to claim reimbursement for dependent care expenses incurred during the specified period (2011-12).
03
Individuals who meet the criteria set forth by the organization or authority responsible for providing reimbursements and have the necessary supporting documentation.
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The elms-dependent care reimbursement form-12pdf is a form used to request reimbursement for dependent care expenses incurred by employees.
Employees who have incurred dependent care expenses and wish to request reimbursement are required to file the elms-dependent care reimbursement form-12pdf.
To fill out the elms-dependent care reimbursement form-12pdf, employees must provide information about the dependent care expenses incurred, including the provider's name, address, and amount paid.
The purpose of the elms-dependent care reimbursement form-12pdf is to request reimbursement for dependent care expenses incurred by employees.
Employees must report information such as the provider's name, address, and amount paid for dependent care expenses on the elms-dependent care reimbursement form-12pdf.
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