Get Dependent Care Fsa Claim Form - Adp Flexible Spending Accounts

Filling out the Dependent Care FSA Claim Form online is an essential step in requesting reimbursement for your dependent care expenses. This guide provides a step-by-step approach to ensure a smooth process, helping you understand each section of the form.

Follow the steps to successfully complete the Dependent Care FSA Claim Form.

1. Press the ‘Get Form’ button to obtain the Dependent Care FSA Claim Form. Open it in the designated editing platform and ensure that you are using the correct version of the form.
2. Begin by filling out Section 1, which is your information. Include your Social Security Number or Employee ID, Company Name, Employee Last Name, Home Zip Code, Daytime Phone Number, and Email. Use capital letters and fill in all ovals as specified.
3. Move to Section 2 to detail your dependent care expenses. Each expense requires a separate line. Fill in the start and end dates of service, the requested amount, provider tax ID or Social Security Number, and attach the relevant receipt. If applicable, include dependent information including their date of birth.
4. In Section 3, review the certification statement carefully. By signing and dating this section, you confirm the accuracy of the information provided and your understanding of the reimbursement rules.
5. If you have additional expenses, utilize the pages provided for continued entries, ensuring to replicate the information structure outlined in the previous steps.
6. Prepare your supporting documentation by copying your receipts onto a white, letter-sized sheet of paper. Ensure all receipts face the same direction and include your Social Security Number or Employee ID at the top.
7. Submit your completed form. For faster processing, send your form and receipts by fax without a cover sheet. Alternatively, mail the documents, ensuring you include correct postage.
8. After submission, expect to receive confirmation of your claim via email if you provided your email address. To expedite reimbursement, consider signing up for Direct Deposit through your ADP account.
9. Remember to keep a copy of your completed form and receipts for your records before exiting.

Start your reimbursement process by completing the Dependent Care FSA Claim Form online today.