Date: 2014-01-23 10:49:08Explanation 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 ListSource URL: hr.uiowa.eduDownload Document from Source Website File Size: 307,37 KBShare Document on Facebook
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