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Dependent Care/Elder Care Spending Account Claim Form Employee Information Employer: Employee ID or last 4 digits of SSN: Name (First, Middle, Last): Street Address: City:State:Zip:Daytime Phone Number:Email:
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How to fill out dependent care account
How to fill out dependent care account
01
Login to your dependent care account online portal
02
Provide your dependent care provider information
03
Enter the amount you want to contribute to the account
04
Submit any necessary documentation such as receipts or invoices for reimbursement
Who needs dependent care account?
01
Parents who have child care expenses
02
Individuals caring for a disabled spouse or elderly family member
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What is dependent care account?
A dependent care account is a pre-tax savings account that can be used to pay for eligible dependent care expenses.
Who is required to file dependent care account?
Individuals who have dependents and incur dependent care expenses are required to file a dependent care account.
How to fill out dependent care account?
To fill out a dependent care account, individuals need to keep track of their eligible dependent care expenses and submit them according to the guidelines of their employer's plan.
What is the purpose of dependent care account?
The purpose of a dependent care account is to help individuals save money on eligible dependent care expenses by using pre-tax dollars.
What information must be reported on dependent care account?
Information such as the amount spent on eligible dependent care expenses, the name and age of the dependent, and the provider's information must be reported on a dependent care account.
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