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Print Form Clear Form State of California FlexElect Plan Year 20 FlexElect Reimbursement Claim Form DPA 351 Rev. 09/10 Please read requirements on reverse side Last Name First Name MI Please Print Daytime phone number Street Address Social Security Number City State Zip Dependent Care Reimbursement Account day care babysitting etc. Name of Dependent Age Dates Care Provided From To Name Address and Taxpayer Identification Number of Care Provider C.
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Pdf FAQ
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The State of California offers employees the FlexElect program with two types of benefits: ✓ Reimbursement accounts for out-of-pocket medical and dependent care expenses. These accounts let you set aside money on a pre-tax basis. This increases your take-home pay and decreases your taxable income.
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The FlexElect Program is a voluntary tax savings program available to eligible State of California employees each plan year (January 1 through December 31). The FlexElect Program encompasses two reimbursement options, Medical Reimbursement Account (MRA) and a Dependent Care Reimbursement Account (DCRA).
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The State of California offers employees the FlexElect program with two types of benefits: ✓ Reimbursement accounts for out-of-pocket medical and dependent care expenses. These accounts let you set aside money on a pre-tax basis. This increases your take-home pay and decreases your taxable income.
-
The FlexElect Program allows state employees to set aside money in a reimbursement account to pay for certain kinds of expenses. Deductions occur before tax withholding, reducing your tax liability. Medical Reimbursement Accounts - Set aside money for eligible medical expenses.
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The FlexElect Program allows state employees to set aside money in a reimbursement account to pay for certain kinds of expenses. Deductions occur before tax withholding, reducing your tax liability. Medical Reimbursement Accounts - Set aside money for eligible medical expenses.
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