Article 5. Payment of Dependent Care Assistance
4.42.501 Claims for reimbursement.
A participant who has elected to receive dependent care assistance for a plan year may apply to the administrator during such plan year for reimbursement of dependent care expenses incurred by the participant during the plan year by submitting an application in writing to the administrator, in such form as the administrator may prescribe, setting forth:
A. The amount, date and nature of the expense with respect to which a benefit is requested;
B. The name of the person, organization or entity to which the expense was paid; and
C. Such other information as the administrator may from time to time require.
Such application shall be accompanied by receipts, cancelled checks or other statements showing the amounts of such expenses, together with any additional documentation which the Administrator may request. (Ord. 5851-NS § 1 (part), 1988)