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Get And Sign Ps Form 3602 R - Fill Out and Sign Printable ...

Get And Sign Ps Form 3602 R - Fill Out and Sign Printable ...-2026

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The document is a claims form for the Dependent Care Assistance Program (DeCAP), which allows employees to request reimbursement for eligible dependent care expenses. It includes sections for employee information, details of services provided, and instructions on how to complete the form. Key points include eligibility criteria, submission deadlines, and requirements for provider signatures. The form emphasizes that reimbursements can only be made for services rendered within the applicable Plan Year.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the EMPLOYEE (PARTICIPANT) INFORMATION section. Ensure you type or print clearly, including your last name, first name, home address, phone number, and email address.
In the DeCAP REIMBURSEMENT REQUESTS section, provide details for each dependent care service. Enter the dependent's last and first names, dates of service, type of service provided, and the reimbursement amount requested.
Make sure to include the provider’s name and address along with their federal tax ID or social security number. This information is crucial for processing your claim.
Finally, sign and date the form in the EMPLOYEE (PARTICIPANT) SIGNATURE section to confirm that all information is accurate and complies with DeCAP rules.

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