Dependent Information Sample Clauses

Dependent Information. If electing health care and/or dependent care flexible spending account, list each qualifying child and/or qualifying relative for health care and/or dependent care flexible spending account expenses. DEPENDENT NAME (First Name/Last Name) DEPENDENT SOCIAL SECURITY NO. DEPENDENT GENDER RELATIONSHIP TO EMPLOYEE DEPENDENT DATE OF BIRTH

Dependent Information. Did you have any changes in dependents during the year? If "Yes," explain Can another person qualify to claim any dependents? Did you have any childcare expenses during the year? Did you have any adoption expenses during the year? Did you have any children under age 19 or a full-time student under age 24 with more than $1900 of unearned income? Provide documentation for proof of dependent related credits (school records, medical records, daycare records, etc.)

Dependent Information. □ □ Are you claiming the same dependents as were reported on your prior year return? If not, why? □ □ Is any dependent you are claiming over age 24? (Note: Spouses are not dependents) □ □ Did you provide over half the support for any other person(s) other than your dependent children during the year? (ie: parent, xxxxxx child, sibling, etc.) YES NO Page 2

Dependent Information. Continued □ □ Do you have any children under age 19 or a full-time student under age 24 with unearned income in excess of $2,100 and/or any dependent who must file a tax return? If yes, provide a copy or indicate if you want me to prepare the returns. Additional fees will apply. □ □ Did you pay for child care for a child under 12 while you worked, looked for work, or while a full-time student? □ □ Are you claiming any child(ren) as the noncustodial parent? If so, provide the signed authorization from the custodial parent granting you the exemption.

Dependent Information. Please list your children who are under the age of twenty-one: (Must be a GCU Benefit Member) Name Date of Birth (MM/DD/YYYY) Gender GCU Client # 1.

Dependent Information. □ □ Did you provide over half the support for any other person(s) during 2018, that you did not list as a dependent on page 1? (ie: parent, xxxxxx child, sibling) □ □ Do you have a child that has already filed a 2018 tax return? If yes, provide a copy □ □ Do you want me to prepare a tax return for your child if one should be filed? Additional fees will apply.