HEALTH CARE SPENDING ACCOUNT REQUEST FOR REIMBURSEMENT Participant Name: _________________________________________ Please print (First, MI, Last)

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Date: 2014-01-23 10:49:08 Explanation of benefits Income tax in the United States Social Security Itemized deduction Health United States FSA debit card Government Medical billing Taxation in the United States Employment compensation Flexible spending account		HEALTH CARE SPENDING ACCOUNT REQUEST FOR REIMBURSEMENT Participant Name: _________________________________________ Please print (First, MI, Last) Add to Reading List Source URL: hr.uiowa.edu Download Document from Source Website File Size: 307,37 KB Share Document on Facebook

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