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1. SaintAnnsSchool LimitedFlexibleSpendingAccount Limited Platform ParticipantInformationandSignatureBysubmittingthisclaimform, I(participantnamedbelow)certifythatIand/ormydependentsincurredthebelowexpenses,
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Expenses incurred by you and your eligible dependents.
Individuals who have incurred expenses for themselves or their eligible dependents.
Expenses should be documented and reported on the appropriate forms provided by the tax authorities.
To claim deductions or tax credits related to the expenses incurred.
Details of the expenses incurred, including dates, amounts, and supporting documentation.
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