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DEPENDENT CARE CONTRACT PARTICIPANT INFORMATION (to be completed by participant) Participant Name: Employer Name: Employee Number/ID: Dependents For Whom Care Will Be Provided (eligible for children

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How to fill out dependent care assistance plan

01

Obtain the dependent care assistance plan form from your employer or HR department.

02

Fill out your personal information such as full name, employee ID, and contact information.

03

Provide details about your dependent(s) including their names, ages, and relationship to you.

04

Indicate the type of care or services needed for your dependent(s) such as daycare, after school care, or summer camp.

05

Specify the amount of money you wish to set aside for dependent care expenses through the plan.

06

Sign and date the form before submitting it to your employer for review and approval.

Who needs dependent care assistance plan?

01

Individuals who have dependents such as children, elderly parents, or disabled family members who require care or assistance while they are at work or unable to provide care themselves.

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What is dependent care assistance plan?

A dependent care assistance plan is a benefit offered by employers to help employees cover the costs of caring for dependents, such as children or elderly family members.

Who is required to file dependent care assistance plan?

Employees who wish to participate in a dependent care assistance plan are required to fill out the necessary forms provided by their employer.

How to fill out dependent care assistance plan?

Employees can fill out a dependent care assistance plan by providing information about their dependent care expenses and requesting the desired contribution amount from their paycheck.

What is the purpose of dependent care assistance plan?

The purpose of a dependent care assistance plan is to help employees save money on eligible dependent care expenses by allowing them to use pre-tax dollars to pay for such expenses.

What information must be reported on dependent care assistance plan?

Employees must report information such as their dependent care expenses, the name and address of the care provider, and the amount requested for pre-tax contribution.

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