Form preview

Get the free Dependent Care Assistance Account (DCA) Election Worksheet

Get Form
Flexible Spending Dependent Care (Daycare) Account (DCA) Overview Maximum DCA Election The maximum amount that can be elected for the DCA is limited to the least of: A. B. C. D.×5,000 for single
We are not affiliated with any brand or entity on this form
4,4
98,753 Reviews
4,5
11,210 Reviews
4,6
715 Reviews
4,6
789 Reviews

Get, Create, Make and Sign dependent care assistance account

Edit
Edit your dependent care assistance account form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your dependent care assistance account form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing dependent care assistance account online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use our professional PDF editor, follow these steps:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.
3
Edit dependent care assistance account. Text may be added and replaced, new objects can be included, pages can be rearranged, watermarks and page numbers can be added, and so on. When you're done editing, click Done and then go to the Documents tab to combine, divide, lock, or unlock the file.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
It's easier to work with documents with pdfFiller than you can have believed. You may try it out for yourself by signing up for an account.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
Learn more about security & compliance
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out dependent care assistance account

Illustration

How to fill out dependent care assistance account

01
Step 1: Obtain the necessary forms from your employer or the dependent care assistance program administrator.
02
Step 2: Fill out the personal information section, including your name, address, and social security number.
03
Step 3: Provide the necessary information about your dependents, such as their names, ages, and relationship to you.
04
Step 4: Calculate and enter your estimated annual dependent care expenses.
05
Step 5: Choose how much money you would like to contribute to the dependent care assistance account each pay period.
06
Step 6: Sign and date the form.
07
Step 7: Submit the completed form to your employer or the dependent care assistance program administrator.

Who needs dependent care assistance account?

01
Individuals who have dependent children or disabled spouses or dependents may benefit from a dependent care assistance account.
02
Those who anticipate incurring expenses for qualified dependent care services, such as child care or adult day care, can use this account to save money on a pre-tax basis.
03
Employers may also offer dependent care assistance accounts as part of their employee benefits package.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.1
Satisfied
57 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

People who need to keep track of documents and fill out forms quickly can connect PDF Filler to their Google Docs account. This means that they can make, edit, and sign documents right from their Google Drive. Make your dependent care assistance account into a fillable form that you can manage and sign from any internet-connected device with this add-on.
You can easily create your eSignature with pdfFiller and then eSign your dependent care assistance account directly from your inbox with the help of pdfFiller’s add-on for Gmail. Please note that you must register for an account in order to save your signatures and signed documents.
The pdfFiller mobile applications for iOS and Android are the easiest way to edit documents on the go. You may get them from the Apple Store and Google Play. More info about the applications here. Install and log in to edit dependent care assistance account.
A dependent care assistance account is a pre-tax benefit account that can be used to pay for eligible dependent care services, such as daycare, preschool, summer day camp, or elder care.
Employees who want to set aside pre-tax money for dependent care expenses are required to enroll in a dependent care assistance account.
To fill out a dependent care assistance account, employees must provide information about their eligible dependent care expenses, such as the name and address of the care provider, the amount paid, and the Social Security number or tax ID number of the care provider.
The purpose of a dependent care assistance account is to help employees save money on dependent care expenses by allowing them to set aside pre-tax dollars to pay for eligible services.
Information such as the name and address of the care provider, the amount paid for dependent care services, and the Social Security number or tax ID number of the care provider must be reported on the dependent care assistance account.
Fill out your dependent care assistance account online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview

Dependent Care Assistance Account is not the form you're looking for?Search for another form here.

Related Features

Cut Off Sentence in the HVAC Contract Template with ease
Cut Off Sentence in the Medical Services Proposal Template with ease
Cut Off Sentence in the Printing Services Proposal Template with ease
Modify Table in the Agreement with ease
Modify Table in the NDA with ease

Relevant keywords

dca stanleybenefits flexstanleybenefits greensboro nc au regs fsa selfcare disbursed prepayment childcare login reimbursement debit reimbursed ineligible dependents irs pre overview incidental incapacitated submission transactions lieu crafts provider day

Related Forms

Form preview
Dav no potrjevanje ra unov - datoteke fu gov
Davao potrjevanje radio / fiscal verification of invoices thine specifikacije / technical specifications version 1.6
Fill Now
Form preview
Reverse Osmosis User s Manual - Osmosi Inversa
Reverse osmosis users manual models intel core ip4 and ip7 table of contents introduction ..
Fill Now
Form preview
Materials Declaration Form - st.com
Materials declaration form ipc form type * sectionals * 1752 version distribute 2 subsectionals *
Fill Now
Form preview
Independent Technical Assessment of Cassini/Huygens Probe Entry, Desce
Nasa engineering and safety center technical assessment report document #: version: rp0567 1.0 page #:
Fill Now
Form preview
Business Associate Agreement - elderaffairs.state.fl.us - elderaffairs
Business associate agreement this business associate agreement is dated, by the florida department of elder
Fill Now
Form preview
DATE ISSUED: 10/10 - twu
Date issued: 10/10 flea: exempt pto: vcs job description title associate head gymnastics coach job
Fill Now
Form preview
Note: The use of the computer or any reference materials is NOT allowe
If you did not receive this exam in a sealed envelope stamped “ni certification,” do
Fill Now
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.