Dependent Daycare Substantiation Requirements

Flexible Spending Account (FSA) Substantiation Policy

As a participant in the Stanford University Dependent Daycare FSA, all Dependent Daycare FSA requests for reimbursement (via mobile app, online, fax, or mail) require a receipt stating the service provided. FSA plans are required to follow IRS rules. Stanford’s FSA administrator, TASC, is required to verify that your submitted expenses are qualified through your daycare provider as established by IRS guidelines. Additional details are listed below.

What kind of receipt is required? You can choose from three convenient options:

1. Receipts from your Dependent Daycare Provider
   With each payment to your daycare provider, request a receipt for the service period (weekly, biweekly, monthly). The receipt should contain the following information:

   • Name of the daycare provider

   • Name of the customer (your name)

   • Name (and ages) of the children receiving care

   • Dates of care

   • Provider Tax Payer ID/Social Security Number

   • Receipt/Invoice Date

   • Provider’s signature or on company’s letterhead (if a daycare center)

   • Payments received (optional)

2. Receipt for Service Form from your Dependent Daycare Provider
   Instead of a custom receipt from the daycare provider, you may use a form to submit all required information. Ask your provider to complete and return the form to you. After that, simply copy, update (dates of service), and submit whenever requesting reimbursement. Download the form (FX-4975 Dependent Daycare Receipt for Service) from the Stanford/Partners website.

3. Dependent Daycare Contract
   If you use the same daycare provider for the entire plan year, consider completing a Dependent Daycare Contract. It serves as a receipt for the entire year (or time you’re with that provider). Complete boxes 1, 2, and 4, and your daycare provider completes box. You may submit the contract in one of two ways:

   • Enter the entire amount for the year on the reimbursement form and submit the contract once. TASC automatically pays from your account each time contributions are applied to your account. Or,

   • Enter the amount for the specified time period on the reimbursement form and submit the contract each time a payment is made.

Download the form (FX-4974 FlexSystem Dependent Daycare Contract) from the Stanford/Partners website.

Dependent Daycare FSA requests for reimbursement must include one of the above-described receipts from your daycare provider. If you have questions or concerns, please call 1-855-842-4913, 8-5, all time zones.

Last updated: June 2017