Get Enrollment Form - State Of California Flex Elect & Pre-tax Parking - Dpa Ca

Filling out the Enrollment Form for the State of California Flex Elect & Pre-Tax Parking program is a straightforward process that allows users to participate in a tax-advantaged parking reimbursement plan. This guide provides clear instructions to help you complete the form accurately and efficiently.

Follow the steps to complete your enrollment form.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Identify the enrollment action you wish to take. Check the appropriate box for either a new enrollment (1.A), change to existing enrollment (1.B), or cancellation of enrollment (1.C).
3. Enter your Social Security number in the specified field (item 2) to ensure accurate identification.
4. Fill in your full name in the designated space (item 3) using the format of first name, middle initial, and last name.
5. In item 5, specify the monthly amount you wish to have deducted for your parking reimbursement account, ensuring it does not exceed the maximum limits outlined under IRC Section 132.
6. Read the agreement clause carefully before signing. This confirms your understanding and acceptance of the program's terms and conditions.
7. Sign and date the form in the designated areas. Provide your work phone number as well.
8. Submit the completed form to your department’s payroll or personnel office for processing, ensuring it is done timely to avoid forfeiture of funds.
9. Once submitted, keep a copy of the completed form for your records. You may also choose to save changes, download a copy, print, or share the document as needed.

Complete your enrollment form online today to take advantage of the pre-tax parking benefits.