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Termination of Eligibility <br /> The eligibility of a Participant will cease upon the earlier of the following: <br /> The date your eligibility ends; <br /> Y The date your employment ends; or <br /> O The date this Plan is terminated <br /> Benefits <br /> Each Participant in the Plan shall be eligible to receive Benefits under the Plan for all Eligible <br /> Employment Related Expenses incurred by the Participant after he became a Participant in the <br /> Plan, subject however to the limitations herein. <br /> Claim for Benefits <br /> Each Participant who desires to receive a Benefit under the Plan for Eligible Employment Related <br /> Expenses incurred for Qualifying Services shall, upon request, submit to the Benefit Administrator <br /> or its designee a written statement containing the following information: <br /> a. name of the Dependent for whom the Qualifying Services are to be performed; <br /> b. the nature of the Qualifying Services performed for the Participant, the cost for which he <br /> wishes to be reimbursed; <br /> c. the relationship, if any, of the person performing the Qualifying Services to the Participant; <br /> d. if the Qualifying Services are being performed by a child of the Participant,the age of that <br /> child; <br /> e. a statement as to where the Qualifying Services will be performed; <br /> £ if the Qualifying Services are being performed in a day care center, a statement that (a)the <br /> day care center complies with all applicable laws and regulations; (b)the day care center <br /> provides care for more than six individuals (other than individuals residing at the center); <br /> and(c)the amount of compensation paid to the center; <br /> g. if the Participant is married, a statement of(a)the Spouse's compensation if he is <br /> employed, or(b) if the Participant's Spouse is not employed, a statement that(1)he is <br /> incapacitated or(2)he is a full-time student attending an educational institution and the <br /> months during the year which he will attend the educational institution; <br /> h. the name, address, and the Federal Tax Identification Number or Social Security Number <br /> of the individual or organization providing the care. The Federal Tax Identification <br /> Number or Social Security Number is not required if the individual or organization is tax- <br /> exempt. <br /> 4 <br />