Yes, you can submit your expense using a completed Dependent Care FSA Claim Attestation form instead of a receipt. This alternative documentation is accepted by the IRS for DCFSA expenses when standard receipts are unavailable
Why?
The IRS requires documentation for all DCFSA expenses to verify their eligibility. While traditional receipts are preferred, the IRS recognizes that some dependent care providers may not provide formal receipts. The Claim Attestation form serves as an acceptable alternative that provides the necessary information for expense verification.
Steps
Download and complete the Dependent Care FSA Claim Attestation form
Note: This form can only be used for Dependent Care FSA purchases and services.
Have your care provider sign the completed form
Submit your expense for reimbursement, using the completed form as your receipt
What to expect
The Benepass team will review your submission within 5 business days. If any additional information is needed, they will contact you directly. Once approved, reimbursement will be processed according to your standard payment method.
Common questions
Do I need to complete a new form for each expense?
Yes, you must complete a new form for each expense submission to ensure proper documentation of individual charges.
What if my provider can provide a partial receipt?
If your provider is able to provide a partial receipt (for example, confirmation of payment but no service dates), then you can use a combination of available receipts along with the completed Attestation form to document your expenses fully.