Child Care Benefit Reimbursement Application

Please complete all applicable sections, submit, and mail, fax or email required supporting documents (see below), to the Fund Office:

Local 338 Benefits Fund, 1505 Kellum Pl, Mineola, NY 11501, Attn.: Child Care Dept. - OR - Fax: 516-281-0249
- OR - email documentation to childcarebenefit@local338.org

Submit one form for each child.

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Required supporting documents: You must submit copies of:

  • Receipt, canceled check and/or paid invoice showing amount paid, and beginning and ending dates of service.  (Reimbursement will not exceed amount you paid, nor Plan's annual maximum.)  Charges for registration fees, transportation, books, and food must not be included (and are NOT covered.) 
  • Your most recent federal tax return.
Period Covered
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Was the child care service documented?
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I hereby certify that I am the individual named on this form in Member Information above.
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