CBS Administrators, LLC
SECTION 132 TRANSPORTATION ELECTION FORM
This enrollment form shall authorize payroll deductions on a pre-tax basis for qualified expenses under the Pre-Tax Transportation Benefit, Section 132(f). To participate in the Program, please complete and submit your form before the 20th of the month. Payroll deductions will begin the following month.
  • ***All future communications will arrive via email address and/or mail address on file ***

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  • SECTION 132 TRANSPORTATION ELECTION AUTHORIZATION MASS TRANSIT AND PARKING BENEFIT

  • 2014 Commuter Benefit maximum is $130.
    Please select your monthly election amount and enter the amount below, the maximum Commuter Benefit is $130 per month and the minimum is $20. The combined total for Parking and Commuter Benefit/Van Pool is $380.
  • I authorize MY EMPLOYER to deduct, on a pre-tax basis, per month from my paychecks, for the purpose of my participation in the Employee Transportation Program. (This program is described in Internal Revenue Code Section 132(f).
  • I authorize MY EMPLOYER to deduct, on a pre-tax basis, per month from my paychecks, for the purpose of my participation in the Employee Parking Benefit Program. (This program is described in Internal Revenue Code Section 132(f).
  • Authorization and Electronic Signature

CBS Administrators, LLC P.O. Box 129, New Almaden, CA 95042 408 323-4888 Phone 408 323-4999 Fax