Dependent Care Reimbursement Fund
If you are eligible, you may receive reimbursement tax-free
to help you pay for the care of a dependent.
This packet contains information that you must read
prior to applying for this Fund.
TABLE OF CONTENTS
Additional information and forms may be obtained by contacting the
New York and New England Regional Work and Family Staff at 646-227-6878 or
or your Local Union representative.
GENERAL INFORMATION ABOUT THE FUND
• What is the Dependent Care Reimbursement Fund?
• Employee Eligibility
• Dependent Eligibility
• Provider Eligibility
• Should my provider be registered or licensed?
• How do I apply to enroll in the Fund?
• How do I get reimbursed from the Fund?
• How does the Fund affect my personal tax responsibilities?
Is there an appeal process if I disagree with a decision?
CHECKLISTS OF WHAT TO DO
• Checklist of what you need to do to enroll in the Fund and
to be reimbursed from the Fund
FORMS NEEDED FOR THE FUND
• Enrollment Application Form
• Care Provider Form
• Certification Form
FREQUENTLY ASKED QUESTIONS
What is the Dependent Care Reimbursement Fund (the Fund)?
The Dependent Care Reimbursement Fund (DCRF), established in 1994 as part of the collective
bargaining agreement, was created to help employees pay a portion of their child or elder care expenses.
Carefully review the information contained in this package. Licensed care, legal custodial arrangements
and total 2005 adjusted gross family income are major determinants for fund participation. In addition to
the application form, you must submit all 2005 IRS 1040 and W2’s for your household. Reimbursement
begins going forward when all your informati