Get the free Dependent Care Supplement Request Form - Chicago Office of ... - chicagofinancialaid...

2015-16 DEPENDENT CARE SUPPLEMENT REQUEST FORM. Students who have ... Return the completed form along with second-party documentation.

How to fill out dependent care supplement request

How to fill out a dependent care supplement request:

1. Obtain the necessary form: The dependent care supplement request form can usually be found on your employer's human resources website or by contacting your HR department.
2. Fill in personal information: Begin by providing your full name, date of birth, employee identification number, and contact information. Make sure to double-check the accuracy of this information.
3. Specify the type of dependent care: Indicate whether you are applying for daycare services, after-school programs, summer camps, or any other type of dependent care assistance. Be specific and provide any additional details required.
4. Provide dependent information: Include the names, ages, and relationships of all dependents who will be receiving care. If you have more than one dependent, make sure to fill out a separate section for each one.
5. Indicate care provider information: Fill in the details of the care provider, such as the name, address, contact number, and any other necessary information. This will help your employer or benefits administrator verify the authenticity of the provider.
6. State the requested amount: Specify the amount of dependent care assistance you are seeking, whether it's a specific dollar amount per month or a percentage of the total cost. This should align with the allowed limits or guidelines provided by your employer's dependent care program.
7. Attach supporting documents: Depending on your employer's requirements, you may need to attach supporting documents, such as receipts, invoices, or contracts from the care provider. Ensure you include all the necessary paperwork to support your request.
8. Sign and date the form: Once you have completed all the required sections, sign and date the form. Your signature verifies the accuracy of the information provided and confirms your understanding of the terms and conditions outlined by your employer's dependent care program.

Who needs a dependent care supplement request?

Employees who have dependents requiring care while they are at work or school often need to submit a dependent care supplement request. This includes individuals with young children, disabled family members, or elderly relatives who rely on assistance from a care provider. The purpose of this request is to seek financial assistance or reimbursement for the costs associated with dependent care, reducing the financial burden on the employee and enabling them to continue working or attending school.

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What is dependent care supplement request?

A dependent care supplement request is a form or application used to request additional financial assistance or support for dependent care expenses.

Who is required to file dependent care supplement request?

Any individual who has dependent care expenses and meets the eligibility criteria set by the organization or institution providing the supplement may be required to file a dependent care supplement request.

How to fill out dependent care supplement request?

To fill out a dependent care supplement request, one must provide information such as personal details, dependent care expenses, proof of income, and any other required documentation as specified on the form.

What is the purpose of dependent care supplement request?

The purpose of a dependent care supplement request is to seek financial assistance or support to help offset the costs of dependent care services, such as childcare, elder care, or disabled dependent care.

What information must be reported on dependent care supplement request?

Information such as personal details, dependent care expenses, proof of income, and any other required documentation must be reported on a dependent care supplement request.

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