Dependent Care Reimbursement Account Request
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DEPENDENT DAYCARE REIMBURSEMENT REQUEST FORM
www.talltreehealth.comPLEASE MAKE COPIES OF THIS FORM FOR FUTURE CLAIMS DEPENDENT DAYCARE REIMBURSEMENT REQUEST FORM (For Qualifying Dependent Care Assistance Plan (DCA) Babysitting Expenses/Elder Daycare Expenses)
Family Medical Leave and/or Dependent Care Leave …
ll743.org4. For all employees who request a leave due to a personal serious illness (not associated with a disability claim), a birth of a child or the need to care for a seriously ill child, spouse, parent, qualifying exigencies or illness/injury of a service member, I must complete the “Certification of Health Care Provider” form (see above for proper form) within 15 calendar days of receiving ...
DEPENDENT CARE FSA FREQUENTLY ASKED QUESTIONS …
www.bates.eduThe expense is incurred for services rendered after the date of your election to receive Dependent Care Reimbursement benefits and during the calendar year to which it applies.