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DOUGLAS COUNTY SCHOOL DISTRICT #4 and AMERICAN FIDELITY ASSURANCE COMPANY SECTION 125 BENEFIT FORM FOR TAXABLE INSURANCE OPT-OUT STIPEND For All Eligible Staff SECTION 125 BENEFIT ELECTION Name of
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It is a form used to report taxable insurance opt-out stipends for the tax year 2016-2017 from a licensed provider.
Employers who provided taxable insurance opt-out stipends to their employees from a licensed provider during the tax year 2016-2017.
The form should be completed with accurate information regarding the taxable insurance opt-out stipends provided to employees from a licensed provider.
The purpose is to report taxable insurance opt-out stipends provided to employees from a licensed provider for the tax year 2016-2017.
The form should include details of the taxable insurance opt-out stipends provided to employees, including the amount and the licensed provider.
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