Get the free TOWN OF URLINGTON FLEXIBLE BENEFIT LAN ORM PLAN
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TOWN OF BURLINGTON, MA
FLEXIBLE BENEFIT PLAN ENROLLMENT FORM
PLAN YEAR: JANUARY 1, 2017, TO DECEMBER 31, 2017,
A. Employee InformationPlease Print Clearly! Name:
Home Address:
Check if New: Instructions
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What is town of urlington flexible?
Town of Burlington flexible refers to a flexible spending account offered to employees by the town of Burlington.
Who is required to file town of urlington flexible?
Employees who wish to participate in the town of Burlington flexible spending account are required to file.
How to fill out town of urlington flexible?
To fill out the town of Burlington flexible spending account, employees need to complete the enrollment form provided by the town's HR department.
What is the purpose of town of urlington flexible?
The purpose of the town of Burlington flexible spending account is to allow employees to set aside pre-tax dollars for eligible medical expenses.
What information must be reported on town of urlington flexible?
Employees must report their desired contribution amount for the flexible spending account.
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