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<br />6: ð ¿-,¿'6 <br /> <br />7.12 <br /> <br />DEPENDENT CARE ASSISTANCE PROGRAM CLAIMS <br /> <br />The Administrator shall direct the payment of all such Dependent Care <br />Assistance claims to the Participant upon the presentation to the Administrator of <br />documentation of such expenses in a form satisfactory to the Administrator. However, in the <br />Administrator's discretion, payments may be made directly to the service provider. In its <br />discretion in administering the Plan, the Administrator may utilize forms and require <br />documentation of costs as may be necessary to verify the claims submitted. At a minimum, the <br />form shall include a statement from an independent third party as proof that the expense has <br />been incurred and the amount of such expense. In addition, the Administrator may require that <br />each Participant who desires to receive reimbursement under this Program for <br />Employment-Related Dependent Care Expenses submit a statement which may contain some <br />or all of the following information: <br /> <br />(a) <br />performed; <br /> <br />The Dependent or Dependents for whom the services were <br /> <br />(b) The nature of the services performed for the Participant, the cost <br />of which he wishes reimbursement; <br /> <br />(c) The relationship, if any, of the person performing the services to <br />the Participant; <br /> <br />(d) If the services are being performed by a child of the Participant, <br />the age of the child; <br /> <br />(e) <br /> <br />A statement as to where the services were performed; <br /> <br />(f) If any of the services were performed outside the home, a <br />statement as to whether the Dependent for whom such services were performed <br />spends at least 8 hours a day in the Participant's household; <br /> <br />(g) <br />statement: <br /> <br />If the services were being performed in a day care center, a <br /> <br />(1) that the day care center complies with all applicable laws and <br />regulations of the state of residence, <br /> <br />(2) that the day care center provides care for more than 6 individuals <br />(other than individuals residing at the center), and <br /> <br />(3) <br />(h) <br /> <br />(1 ) <br />(2) <br /> <br />of the amount of fee paid to the provider. <br /> <br />If the Participant is married, a statement containing the following: <br /> <br />the Spouse's salary or wages if he or she is employed, or <br /> <br />if the Participant's Spouse is not employed, that <br /> <br />(i) <br /> <br />he or she is incapacitated, or <br /> <br />(ii) he or she is a full-time student attending an educational <br />institution and the months during the year which he or she <br />attended such institution. <br /> <br />19 <br />