Fillable HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES ELIGIBILITY FORM (Hood College)

Fill Online, Printable, Fillable, Blank HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES ELIGIBILITY FORM (Hood College) Form

Use Fill to complete blank online HOOD COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES ELIGIBILITY FORM (Hood College)

On average this form takes 7 minutes to complete

The HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES ELIGIBILITY FORM (Hood College) form is 1 page long and contains:

  • 2 signatures
  • 0 check-boxes
  • 20 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Hood College

BROWSE HOOD COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES
ELIGIBILITY FORM AND CERTIFICATION
Semester: _______________/________________ (Ex: Spring/2020)
Term Year
Please note that application for educational benefits must be made in each semester for which they are
requested.
Employee Name:
Last First M.I.
Student Information:
Name:
Last First M.I.
Relationship to employee:
Self: Spouse: Dependent Child:
Student ID No.:
Graduate: Undergraduate: Number of Credits:
I understand that Hood College (the “College”) reserves the right to request appropriate proof of the relationship between me
and any student receiving educational benefits by virtue of my employment with the College, including but not limited to
proof of marital status; proof that the recipient qualifies as a dependent child in accordance with IRS regulations (see IRS
Publication 501, Exemptions, Standard Deduction, and Filing Information).
I understand that educational benefits are subject to the availability of space; that any educational benefits granted will be
revoked if my employment is terminated (whether by me or the College); and that reapplication for educational benefits must
be made in each semester for which they are requested, in accordance with College policy.
I understand that I am not eligible for this benefit until I have completed my 90-day introductory employment period in a
benefit eligible position. In the event that my employment with the College ends, I agree full restitution will be made to the
College for any tuition owed due to the cessation of educational benefits.
[This paragraph should be completed for any dependent child receiving educational benefits. If not applicable, cross out this
paragraph.]
I certify that qualifies as my dependent child in accordance with IRS regulations. I further certify
that (s)he was claimed by me as a dependent on my most recent Federal income tax return, or would have been eligible to be
claimed by me as a dependent if not otherwise claimed by the child’s other parent, and that (s)he will so qualify to be claimed
by me as a dependent (or would so qualify, if not claimed by the child’s other parent) for the time period that is covered by the
semester for which tuition benefits are requested.
Employee Signature Date
Please return completed form to the Human Resources Office (ROBERTSV@HOOD.EDU)
TO BE COMPLETED BY HR:
Employment Status: Date of hire: _________________ Tuition Remission Eligibility Date: __________________
Full-Time: ____ Part-Time: ______
Full-Time Equivalency Percentage:
Graduate Research Assistant: _____
Human Resources Signature Date
click to sign
signature
click to edit
click to sign
signature
click to edit
HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES
SUMMARY OF BENEFITS
A summary of the Hood College Educational Benefit (the “Benefit”) and certain tax implications follows. The Benefit
applies to tuition only; it does not apply to fees, supplemental costs, class and lab fees, books, room and board, or other
incidental expenses incurred by the employee or any student receiving the Benefit by virtue of the employee’s
employment with Hood College. See Hood College Staff Manual, Section 723.3, Guidelines, paragraph 1. The amount of
the Benefit for any given employee shall be equal to the educational costs that would otherwise be incurred by the
employee at the College (for himself or herself, or for any category of individual listed below), multiplied by a percentage
that is equal to the employee’s full-time equivalency percentage.
Payment of all fees not covered by the Benefit is subject to Hood College’s payment and late fees policies.
EDUCATIONAL BENEFITS FOR EMPLOYEES
The Benefit allows the following individuals to attend Hood College, pursuant to the following guidelines and limitations:
1) Employees:
• Undergraduate courses
o Tuition is tax-free
• Graduate courses
o Tuition is tax-free up to $5,250; all amounts thereafter are taxable income.
2) Graduate Research Assistants:
• Graduate courses
o Tuition is tax-free
3) Spouses:
• Undergraduate courses
o Tuition is tax-free
• Graduate courses
o Tuition is taxable income
4) Children (including by birth or adoption), Step-Children, and Foster Children:
• Undergraduate courses
o Tuition is tax-free
• Graduate courses
o Tuition is taxable income
Taxable income related to the Benefit is calculated and reflected in compensation through-out the year. FICA/Medicare is
withheld on all taxable amounts. All taxable income related to the Benefit received by an employee in a single calendar
year will be reflected on the employee’s Form W-2 for such year. The determination of an employee’s federal and
state tax liability are the responsibility of the employee. Please consult with your personal tax advisor.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

HOOD COLLEGE EDUCATIONAL BENEFITS FOR EMPLOYEES ELIGIBILITY FORM (Hood College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 21 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document