Dependent Care Spending Account Claim Form - Use this form to submit your claims for reimbursement of. Web dependent care account claim and provider documentation form. Web there are three ways to submit a dependent care fsa claim: Log in to your account at www.fsafeds.com to submit your claim electronically with. Use the fsafeds app to have the dependent care provider certify.
Use the fsafeds app to have the dependent care provider certify. Use this form to submit your claims for reimbursement of. Web there are three ways to submit a dependent care fsa claim: Log in to your account at www.fsafeds.com to submit your claim electronically with. Web dependent care account claim and provider documentation form.