[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-detail-335019-en":53,"doc-seo-335019-105":74},{"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":5,"data":54},{"doc_id":55,"user_id":56,"nickname":57,"user_avatar":58,"doc_module":9,"category_id":20,"category_name":21,"doc_title":59,"doc_description":60,"doc_content":61,"file_id":62,"file_url":63,"file_type":64,"file_size":65,"view_count":66,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":67,"language_code":68,"site_id":69,"html_lang":68,"table_of_contents":70,"faqs":71,"seo_title":72,"seo_description":60,"update_tm":73,"read_time":4},335019,5909892330395,"Fans","https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Section 125 Flexible Benefits Plan - Dependent Daycare Receipt","This document is a formal receipt template for the Section 125 Flexible Benefits Plan, specifically designed for Dependent Daycare expenses administered by Educators Benefit Consultants, LLC. It provides a structured format for participants to document essential service details, including parent and child information, dates of service, total fees, and comprehensive provider identification such as address, telephone number, and Tax ID/SSN. The form includes critical compliance notices regarding federal income tax eligibility, stipulating that services provided by dependents, or children under age 19, are excluded from reimbursement. Furthermore, it clarifies that claimants must be under age 13 or meet specific qualifying restrictions. This receipt is intended to be submitted as supporting documentation alongside a primary reimbursement claim form to facilitate the verification and processing of tax-advantaged childcare benefit payments. The template serves as a standardized record-keeping tool for third-party administration workflows.","# Section 125 Flexible Benefits Plan -Dependent Daycare Receipt\n\nParent's Name:                                                                \n\n| Child's Name   |  |\n| --- | --- |\n|  |  |\n|  |  |\n|  |  |\n|  |  |\n\nDate of Service:From                            \nFee for Service:$.                          \nProvider's Name:                           \nAddress:                                                            \nTelephone Number:.                     \nTax ID/SSN:                                                          \nProvider's Signature:                                              \n·Notice to Cafeteria Plan Participant:No payment may be made under the plan if the serviceprovider is your dependent for federal income tax purpose,or is your child or stepchild andis under age 19.The dependent you are claiming must be under age 13 or have qualifyingrestrictions.  \nTHIS FORM MUST BE SUBMITTED ALONG WITH A REIMBURSEMENT CLAIM FORM.EBC DCRCPT 03/05","cbCaicK229HYniqc","https://ap.wps.com/l/cbCaicK229HYniqc","pdf",24590,9,"English","en",105,"# Dependent Daycare Receipt Details\n## Participant and Child Information\n## Service and Provider Verification\n## Compliance and Reimbursement Notices","[{\"question\":\"Who is the administrator for this plan?\",\"answer\":\"The plan is administered by Educators Benefit Consultants, LLC.\"},{\"question\":\"What are the age requirements for dependents receiving care?\",\"answer\":\"Dependents must generally be under age 13, unless they have other qualifying restrictions.\"},{\"question\":\"Can I claim reimbursement if the service provider is my own child?\",\"answer\":\"No, payment cannot be made if the service provider is your child or stepchild under the age of 19, or if they are your dependent for federal income tax purposes.\"}]","Section 125 Flexible Benefits Plan - Dependent Daycare Receipt | PDF",1790009270,{"code":4,"msg":75,"data":76},"ok",{"site_id":69,"language":68,"slug":77,"title":59,"keywords":78,"description":60,"schema_data":79,"social_meta":135,"head_meta":137,"extra_data":139,"updated_unix":140},"section-125-flexible-benefits-plan-dependent-daycare-receipt","",{"@graph":80,"@context":134},[81,97,117],{"@type":82,"itemListElement":83},"BreadcrumbList",[84,88,91,94],{"item":85,"name":86,"@type":87,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":89,"name":10,"@type":87,"position":90},"https://docshare.wps.com/template/",2,{"item":92,"name":21,"@type":87,"position":93},"https://docshare.wps.com/template/invoices/",3,{"item":95,"name":59,"@type":87,"position":96},"https://docshare.wps.com/template/section-125-flexible-benefits-plan-dependent-daycare-receipt/335019/",4,{"url":95,"name":59,"@type":98,"image":99,"author":104,"headline":59,"publisher":106,"fileFormat":109,"inLanguage":68,"description":60,"dateModified":110,"datePublished":111,"encodingFormat":109,"isAccessibleForFree":112,"interactionStatistic":113},"DigitalDocument",{"url":100,"@type":101,"width":102,"height":103},"https://docshare.wps.com/thumbnails/section-125-flexible-benefits-plan-dependent-daycare-receipt/335019.png","ImageObject",442,249,{"name":57,"@type":105},"Person",{"url":85,"name":107,"@type":108},"DocShare","Organization","application/pdf","2026-10-16","2026-09-21",true,{"@type":114,"interactionType":115,"userInteractionCount":66},"InteractionCounter",{"@type":116},"ViewAction",{"@type":118,"mainEntity":119},"FAQPage",[120,126,130],{"name":121,"@type":122,"acceptedAnswer":123},"Who is the administrator for this plan?","Question",{"text":124,"@type":125},"The plan is administered by Educators Benefit Consultants, LLC.","Answer",{"name":127,"@type":122,"acceptedAnswer":128},"What are the age requirements for dependents receiving care?",{"text":129,"@type":125},"Dependents must generally be under age 13, unless they have other qualifying restrictions.",{"name":131,"@type":122,"acceptedAnswer":132},"Can I claim reimbursement if the service provider is my own child?",{"text":133,"@type":125},"No, payment cannot be made if the service provider is your child or stepchild under the age of 19, or if they are your dependent for federal income tax purposes.","https://schema.org",{"og:url":95,"og:type":136,"og:title":59,"og:site_name":107,"og:description":60},"article",{"robots":138,"canonical":95},"index,follow",{"doc_id":55,"site_id":69},1790539214]