Get the free Dependent Care Claim Form - FY 2016
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Alabama State Department of Education
Office of Financial Management
LEA Accounting
P O Box 302101
Montgomery, Alabama 361302101
Revised 1/16ALL CLAIMS FOR
REIMBURSEMENT MUST BE
SUBMITTED BY
SEPTEMBER
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How to fill out dependent care claim form
How to fill out dependent care claim form
01
Obtain the dependent care claim form from your employer or insurance provider.
02
Fill out the form with accurate information about the dependent needing care, such as their name, date of birth, and relationship to you.
03
Provide details about the care received, including the name and address of the care provider, dates of service, and the amount paid for care.
04
Attach any required documentation, such as receipts or invoices for the care provided.
05
Review the completed form for accuracy and completeness before submitting it to the appropriate party.
Who needs dependent care claim form?
01
Individuals who have dependents that require care while they are at work or school.
02
Employees who participate in a dependent care flexible spending account (FSA) program.
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What is dependent care claim form?
The dependent care claim form is a document used to request reimbursement for eligible dependent care expenses incurred while the employee is working or looking for work.
Who is required to file dependent care claim form?
Employees who have incurred eligible dependent care expenses for their dependents while they are working or seeking employment are required to file the dependent care claim form.
How to fill out dependent care claim form?
To fill out the dependent care claim form, you need to enter your personal and dependent information, provide details about the care provider, specify the dates of care, and list the expenses incurred. Ensure to attach any required receipts or documentation.
What is the purpose of dependent care claim form?
The purpose of the dependent care claim form is to allow employees to claim reimbursements for eligible expenses related to the care of their dependents while they are working or looking for work.
What information must be reported on dependent care claim form?
The information that must be reported includes the name and address of the care provider, the amount spent for care, the dates of service, and information about the dependents for whom care was provided.
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