Please mail the signed report with all original receipts and a Company cheque to:
BeneFitsMyWay- Box 408 - 370, 5222 130th Avenue SE Calgary, AB T2Z 0G4
| Total Claim Amount | A | ||
| Processing Fees | |||
| Admin fee | |||
| Paper claim fee | |||
| Manual cheque fee | |||
| B | Total | ||
| GST/HST on B | C | ||
| Premium Tax on A+B | D | ||
| PST on A | E | ||
| Total (A+B+C+D+E) |