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Get Debit Card Substantiation Form

Flexible Spending Account (FSA) Debit Card Substantiation Form FSA Debit Card Receipt Submission Use this form only to submit receipts for validation of FSA debit card transactions. Requests for reimbursement.

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  2. Open the form in the online editing tool.
  3. Go through the instructions to learn which info you have to include.
  4. Click on the fillable fields and put the required data.
  5. Add the relevant date and insert your electronic signature as soon as you fill out all of the fields.
  6. Look at the completed form for misprints along with other errors. In case you necessity to change some information, the online editor as well as its wide range of instruments are ready for your use.
  7. Download the completed document to your computer by hitting Done.
  8. Send the e-document to the intended recipient.

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