This document is an account statement from FSAFEDS for Donald Hadley showing the balance remaining in his 2013 Health Care Flexible Spending Account. It indicates that as of January 27, 2014, Hadley had elected $800 for the year and had received $392.27 in reimbursements, leaving a remaining balance of $407.73 available for eligible medical expenses incurred between January 1, 2013 and March 15, 2014, as long as claims are postmarked by April 30, 2014.