Get Moneyplu$ Claim Form - Academicdepartments Musc

Filling out the MoneyPlu$ Claim Form is a critical step in managing your flexible spending account effectively. This guide provides a clear, step-by-step approach to ensure your claim is processed efficiently and accurately.

Follow the steps to complete the MoneyPlu$ Claim Form online.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. In the personal data section, fill in your name, home phone number, street address, city, state, and zip code. Make sure to enter your Social Security number or Employee ID number, your employer's name, and your daytime phone number. If you have moved recently, check the box indicating this is a new address.
3. Read the certification statement carefully. You are agreeing to use your flexible spending account (FSA) for IRS-qualified expenses and confirming that you will not seek reimbursement through any other source. Sign and date the form at the bottom to complete this section.
4. For the payment type section, check the boxes that apply to your situation. Enter the amounts associated with each claim type, ensuring you attach the necessary documentation for expenses requiring it.
5. Complete the Medical FSA area by providing details about the medical services. Fill in the service date, the name of the person receiving the service, their relationship to you, the service provider's name, and the amounts for which you are requesting reimbursement.
6. If you are claiming dependent care expenses, complete the relevant section with the required information, including the name of the person receiving care, their age, and the service provider’s name and address. Ensure you include the appropriate service dates and amounts.
7. After filling out all sections, review the form to ensure accuracy. Remember to keep copies for your records before submitting.
8. You can then save your changes, download the form, print it, or share it as needed.

Begin your online completion of the MoneyPlu$ Claim Form today!