Dependent Care Account Claim and Provider Documentation Form - Arkansas

Dependent Care Account Claim and Provider Documentation Form - Arkansas

Dependent Care Account Claim and Provider Documentation Form is a legal document that was released by the Arkansas Department of Transformation and Shared Services - a government authority operating within Arkansas.

FAQ

Q: What is a Dependent Care Account?
A: A Dependent Care Account is a type of flexible spending account (FSA) that allows you to set aside pre-tax dollars to pay for eligible dependent care expenses.

Q: Who can use a Dependent Care Account?
A: Employees who have eligible dependents, such as children or disabled adults, may use a Dependent Care Account.

Q: What expenses are eligible for reimbursement from a Dependent Care Account?
A: Eligible expenses include child care, before and after school care, day care centers, preschool programs, and summer day camps.

Q: How does a Dependent Care Account work?
A: You contribute a certain amount of money from your paycheck to your Dependent Care Account before taxes are taken out. You can then use these funds to pay for eligible dependent care expenses throughout the year.

Q: Do I need to submit documentation for expenses paid from a Dependent Care Account?
A: Yes, you are generally required to submit documentation, such as receipts or provider invoices, to support your claims for reimbursement.

Q: What is the Dependent Care Account Claim and Provider Documentation Form?
A: The Dependent Care Account Claim and Provider Documentation Form is a form that you must complete and submit along with your supporting documentation when requesting reimbursement from your Dependent Care Account.

Q: What should I include when submitting the Dependent Care Account Claim and Provider Documentation Form?
A: When submitting the form, you should include all required information, such as your name, contact information, and the amount of the expense you are requesting reimbursement for.

Q: Is there a deadline for submitting the Dependent Care Account Claim and Provider Documentation Form?
A: Yes, there is typically a deadline for submitting the form and supporting documentation, so it is important to submit your claims in a timely manner.

Q: How long does it take to receive reimbursement from a Dependent Care Account?
A: The time it takes to receive reimbursement can vary, but it is typically within a few weeks of submitting a complete and accurate claim.

ADVERTISEMENT

Form Details:

  • Released on June 1, 2017;
  • The latest edition currently provided by the Arkansas Department of Transformation and Shared Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Arkansas Department of Transformation and Shared Services.

Download Dependent Care Account Claim and Provider Documentation Form - Arkansas

4.6 of 5 (22 votes)
  • Dependent Care Account Claim and Provider Documentation Form - Arkansas

    1

  • Dependent Care Account Claim and Provider Documentation Form - Arkansas, Page 2

    2

  • Dependent Care Account Claim and Provider Documentation Form - Arkansas, Page 1
  • Dependent Care Account Claim and Provider Documentation Form - Arkansas, Page 2
Prev 1 2 Next
ADVERTISEMENT