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HOW TO REQUEST REIMBURSEMENT FROM YOUR DEPENDENT CARE ACCOUNT This form is to be used to request reimbursement for dependent care expenses only. To view a detailed list of eligible dependent care
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How to fill out dependent care flexible spending

01
Gather necessary information such as the provider's name, address, and Social Security or tax identification number.
02
Determine your eligible expenses, which may include childcare services, after-school programs, and summer day camps.
03
Calculate your expected expenses for the year and determine the maximum amount you can contribute to the dependent care flexible spending account.
04
Enroll in your employer's flexible spending account program and elect the desired contribution amount.
05
Keep track of your dependent care expenses by saving receipts and documentation.
06
Submit reimbursement requests to your employer's flexible spending account administrator, along with the necessary documentation.
07
Receive reimbursement for eligible expenses within the specified time frame.
08
Monitor your account balance and plan your future dependent care expenses accordingly.
09
Review the rules and regulations surrounding dependent care flexible spending to ensure compliance.

Who needs dependent care flexible spending?

01
Working parents or guardians who have dependent children under the age of 13.
02
Parents or guardians who require childcare services in order to work or attend school.
03
Families with expenses related to the care of a disabled or elderly dependent.
04
Those looking to save money on their eligible dependent care expenses through pre-tax contributions.
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Dependent care flexible spending is a benefit provided by some employers that allows employees to set aside pre-tax dollars to pay for eligible dependent care expenses.
Employees who have opted for dependent care flexible spending as part of their benefits package are required to file.
To fill out dependent care flexible spending, employees must submit eligible expenses along with documentation such as receipts or invoices to the employer's designated administrator.
The purpose of dependent care flexible spending is to help employees save money on eligible dependent care expenses by using pre-tax dollars.
Employees must report the amount of money set aside for dependent care flexible spending and provide documentation for eligible expenses.
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