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Sentinel Benefits Claim Form

Sentinel Benefits Claim Form

Create a custom sentinel reimbursement claim form 0 that meets your industry’s specifications.

IMPORTANT INFORMATION KEEP A COPY OF THIS FORM AND RECEIPTS FOR YOUR RECORDS Please see page 2 for additional information* Please complete the appropriate section for each account you are submitting 4. claims i*e* Dependent Care Account/Healthcare Account. Attach the documentation in the order in which you have the expenses listed* 5. The documentation must contain the date s of service expense/purchase incurred and the name of the service provider. Cancelled checks and credit card receipts are...
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