Get Please Attach The Required Documentation To This Form And Send To - Hr Wfu

This guide provides a step-by-step approach to completing the Please Attach The Required Documentation To This Form And Send To - Hr Wfu online. It is designed to assist users in submitting their Flexible Spending Account Reimbursement Claim Form with ease and accuracy.

Follow the steps to successfully complete your reimbursement claim form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by filling in your employer's name in the designated field labeled 'Your Employer.'
3. Provide the number of pages you are faxing in the 'Number of pages in this fax' section.
4. Enter your personal details including your 'Employee Name,' 'Social Security Number,' 'Daytime Phone Number,' and 'Email.'
5. In the 'Health Care Expenses' section, mark the appropriate box indicating whether you have insurance for the expenses or not.
6. If you have insurance, attach a copy of the explanation of benefits (EOB) statement as required. If you do not, submit an itemized statement with the necessary details.
7. Complete the provided fields related to health care expenses, including the name of the service provider, relationship, date of service, type of expense, and the reimbursement request amount.
8. For dependent daycare expenses, fill in the relevant details including service provider information, dependent name and age, relationship, date of service, and reimbursement amount.
9. Calculate the total reimbursement requested by adding the amounts from health care and dependent daycare sections. Write the total in the designated space.
10. Sign and date the form where indicated, certifying the expenses claimed and ensuring all information is accurate and complete.
11. Finally, review your completed form. Save any changes, then print, share, or submit your document as required. Ensure to retain copies of all submitted documents for your records.

Complete your Flexible Spending Account reimbursement claims online for a smoother and efficient process.