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OR Signature Date Printed Name Employee ID or SSN This form must reach 1115 Truxtun Ave. 1st Floor Bakersfield CA 93301 by 5 00 p.m. on November 23 2016 TO BE COMPLETED BY HEALTH BENEFITS DEPARTMENT Date of Hire Plan Code Effective Date 1/01/2017. Kern County Human Resources Health Benefits Open Enrollment Change of Flex Tax Status Effective January 1 2017 Instructions Use this form to change any pre-tax eligible deduction from pre-tax to post-tax or vice versa. Pre-tax eligible programs...
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How to fill out change of flex tax

01
Step 1: Obtain a change of flex tax form from your employer or the appropriate tax authority.
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Step 2: Read the instructions on the form carefully to understand the requirements.
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Step 3: Gather all necessary documents such as proof of change in flex benefits or income changes.
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Step 4: Fill out the form accurately and legibly, providing all requested information.
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Step 5: Include any supporting documentation required by the form, such as receipts or proof of expenses.
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Step 6: Double-check your form for any errors or missing information.
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Step 7: Sign and date the form, indicating your consent and agreement with the provided information.
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Step 8: Submit the completed form to your employer or the designated tax authority as instructed.
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Step 9: Keep a copy of the filled-out form and any supporting documents for your records.
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Step 10: Follow up with your employer or tax authority to ensure your change of flex tax request is processed.

Who needs change of flex tax?

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Individuals who have experienced a change in their flexible benefits or income may need to fill out a change of flex tax form.
02
Employees who are eligible for flex benefits and wish to revise the tax allocation for those benefits might need to complete this form.
03
Anyone who wants to adjust the tax treatment of their flexible benefits based on a new situation or change in income may need to fill out a change of flex tax form.
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This form is required for individuals who want to update their taxation status related to flex benefits offered by their employer.
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People who have experienced a significant change in their financial situation and need to modify their tax allocation may need to complete this form.
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The change of flex tax is a document used to update or modify the flexible spending account information for an employee.
Any employee who has a flexible spending account must file a change of flex tax if there are changes to their account information.
To fill out a change of flex tax, employees must provide their personal information, account details, and any changes that need to be made.
The purpose of change of flex tax is to ensure that an employee's flexible spending account information is up to date and accurate.
Employees must report any changes to their personal information, dependent information, contribution amount, or eligible expenses on the change of flex tax.
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