Free FSA Expense Log PDF for Receipts

Highlight how FSAs work, the risk of forfeiting funds, and why keeping a PDF log of expenses and reimbursements protects you.

When to use this

• You need to submit receipts to your FSA administrator before the deadline.
• You want to prove how much of your FSA balance has been spent or reimbursed.
• You track dependent care or medical FSA expenses and need totals by year.

How to do it (fast)

1. Collect your FSA receipts, EOBs, and portal confirmations.
2. Open the FSA Expense Log tool and enter your plan year and sponsor.
3. Add each expense with date, category, and amount, marking what was reimbursed.
4. Download the PDF and save it with your tax or employer benefit records.

Why this helps

• Prevents last-minute scrambles before use-it-or-lose-it deadlines.
• Shows reimbursed vs. unreimbursed totals for your administrator or CPA.
• Keeps medical and dependent care claims organized in one PDF log.

Related tools

• FSA Expense Log PDF Tool
• HSA Expense Log PDF
• Medical Expense Reimbursement Log

Not legal advice. Courts set their own rules. Keep your original records.