Health Care/Dependent/Care Reimbursement Account Claim Form
Form:
claim_form.pdf [1]
Format:
PDF
Turn in within 1st 60 days of hire date or during Open Enrollment only
Routing Instructions:
Human Resources
Category:
- Benefit [2]
Turn in within 1st 60 days of hire date or during Open Enrollment only
Human Resources
Links
[1] https://forms.humboldt.edu/sites/default/files/claim_form.pdf
[2] https://forms.humboldt.edu/categories/benefit