[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-335013-105":53,"doc-detail-335013-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","benx-cafeteria-plan-dependent-daycare-receipt","BenX Cafeteria Plan - Dependent Daycare Receipt","","This document serves as a formal Dependent Daycare Receipt for the BenX Cafeteria Plan. It provides a structured format for participants to document daycare expenses, including the names and ages of children, dates of service, and service fees. The form includes sections for both children under 13 and dependent adults or older children with qualifying restrictions. It also collects essential provider information, such as contact details and Tax ID/SSN, and outlines eligibility requirements regarding dependent status and age restrictions for plan reimbursement.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":21,"@type":70,"position":76},"https://docshare.wps.com/template/invoices/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/benx-cafeteria-plan-dependent-daycare-receipt/335013/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/benx-cafeteria-plan-dependent-daycare-receipt/335013.png","ImageObject",442,249,{"name":88,"@type":89},"Ben ","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-17","2026-09-21",true,{"@type":98,"interactionType":99,"userInteractionCount":8},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What information is required for the daycare provider?","Question",{"text":108,"@type":109},"The provider must supply their name, address, city, state, zip code, telephone number, and their Tax ID or SSN.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Who is ineligible for reimbursement under this plan?",{"text":113,"@type":109},"No payment can be made if the service provider is your dependent for federal income tax purposes, or if the provider is your child or stepchild under age 19.",{"name":115,"@type":106,"acceptedAnswer":116},"What is the age requirement for a dependent child on this form?",{"text":117,"@type":109},"The dependent child being claimed must be under age 13 unless they have specific qualifying restrictions.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},335013,1791334962,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":20,"category_name":21,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":8,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Cafeteria Plan  \nDependent Daycare Receipt  \nParent’s Name   \n\n| Child’s Name | Age | DATE OF SERVICE\u003Cbr>From: To: |  |  | FEE for Service |\n| --- | --- | --- | --- | --- | --- |\n| 1 |  |  |  |  | $ |\n| 2 |  |  |  |  | $ |\n| 3 |  |  |  |  | $ |\n| 4 |  |  |  |  | $ |\n| 5 |  |  |  |  | $ |\n|  |  |  |  |  |  |\n|  |  |  |  | Total: $ |  |\n|  |  |  |  |  |  |\n| Name of Dependent Adult or Child over 13 with qualifying restrictions |  | DATE OF SERVICE\u003Cbr>From: To: |  |  | FEE for Service |\n| 1 |  |  |  |  | $ |\n\n\n| Provider Information |  |\n| --- | --- |\n| Provider’s Name: |  |\n| Address |  |\n| City State Zip |  |\n| Telephone Number: |  |\n| Tax ID/SSN: |  |\n| | Daycare Provider Date |\n\nNotice to Cafeteria Plan Participant: No payment may be made under the plan if the service provider is your dependent for federal income tax purpose, or is your child or stepchild and is underage 19. The dependent you are claiming must be under age 13 or have qualifying restrictions.  \nATTACH THIS RECEIPT TO A COMPLETED CAFETERIA PLAN CLAIM FORM  \nBen-X, LLC  \nEmail: [support@benxco.com](support@benxco.com) 􀁺 FAX: (801) 224-1903 􀁺 Website: [www.MyBenX.com](www.MyBenX.com)  \n©Ben-X, LLC 2008  \nRev 10.01","cbCaihxx36sbrJcx","https://ap.wps.com/l/cbCaihxx36sbrJcx","pdf",463748,"English","# Dependent Daycare Receipt Details\n## Child Care Information\n## Adult or Qualifying Dependent Care\n## Provider Information\n## Participation Notice","[{\"question\":\"What information is required for the daycare provider?\",\"answer\":\"The provider must supply their name, address, city, state, zip code, telephone number, and their Tax ID or SSN.\"},{\"question\":\"Who is ineligible for reimbursement under this plan?\",\"answer\":\"No payment can be made if the service provider is your dependent for federal income tax purposes, or if the provider is your child or stepchild under age 19.\"},{\"question\":\"What is the age requirement for a dependent child on this form?\",\"answer\":\"The dependent child being claimed must be under age 13 unless they have specific qualifying restrictions.\"}]","BenX Cafeteria Plan - Dependent Daycare Receipt | PDF",1790009224]