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JFK BENEFIT MANAGEMENT, INC. FLEXIBLE BENEFIT PLAN REQUEST FOR REIMBURSEMENT EMPLOYEES. S. #ADDRESS CITYSTATEZIPMEDICAL REIMBURSEMENT Complete one line for each expense you wish reimbursed under your

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Complete one line is for reporting all income and deductions on a single line on a tax form.

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Any individual or entity that receives income and has deductions to report may be required to file complete one line.

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To fill out complete one line, gather all income and deduction information, then report the totals on the designated line on the tax form.

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All income received and deductions taken throughout the tax year must be reported on complete one line.

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