Fillable Student Debt Relief Fund for SEIU Local 500 (Montgomery Schools)

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Student Debt Relief Fund for SEIU Local 500 (Montgomery Schools)

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The Student Debt Relief Fund for SEIU Local 500 (Montgomery Schools) form is 2 pages long and contains:

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INSTRUCTIONS
Article 28 (I) Career Development and Training, of the Agreement Between SEIU Local 500, CTW and the Board of Education
of Montgomery County, established a Student Debt Relief Fund for the benefit of MCPS employees covered under the
Agreement to reimburse employees for personal student loan debt incurred prior to the member’s employment with
MCPS, under rules agreed to by the parties. This fund is meant to pay for programs at universities, trade schools, training
programs, and other institutes of learning that provide supporting service professionals education to improve their job
performance and serve the MCPS community.
The goal is to provide assistance up to 5% of your original loan per year, paying off not more than 50% of the balance
incurred prior to employment with MCPS, not to exceed your existing balance. The fund is a set amount each year and the
goal is to serve as many supporting service employees as possible at a meaningful level.
To request this benefit, please complete, sign, and return this form, with all required documentation, by March 31. You
may fax the signed form and required documentation to 301-279-3651 or 301-279-3642, or e-mail a PDF of the signed
form and all attachments to ERSC@mcpsmd.org. Please only submit the form via one method. Submitting via multiple
methods can cause errors and delay the processing of your submission. Applications that are incomplete, missing
documentation, or unsigned will not be processed and will be returned to the employee.
IMPORTANT INFORMATION FOR APPLICANTS
You are obligated for any tax liability associated with reimbursements received from the Student Debt Relief Fund. You
should contact your tax-preparer for more information on how this could impact your obligation to pay income taxes.
The student debt relief fund is a fund only to pay off debt of MCPS supporting service bargaining unit employees. Student
debt taken for a child’s or relative’s education is not eligible. Documentation is updated annually. ALL PAPERWORK IS DUE
BY March 31. Incomplete submissions will not be considered and will be returned.
Check List (for new applicants)
Have you attached:
o
Official transcripts from all educational institutions?
o
Documentation of your student debt from your date
of hire at MCPS
o
Documentation from December 31st of last year
o
Documentation showing that you are currently in
good standing
Check List (for previously approved applicants)
Have you attached:
o
Documentation from December 31st of last year
o
Documentation showing that you are currently in good
standing
ELIGIBILITY REQUIREMENTS FOR SEIU STUDENT DEBT RELIEF FUND
• Employed for a minimum of twelve months as a permanent employee in an SEIU bargaining unit position
• The employee has attended a workshop on understanding the student debt relief program and additional student debt relief
options for which the employee may be eligible.
• The debt is for studies relevant to any employment with MCPS.
• The student debt was incurred prior to the employee’s employment with MCPS, for which the employee is currently in loan
repayment.
• The employee’s loan repayment is in good standing with the lender to whom the eligible student debt is being repaid.
Student Debt Relief Fund for
SEIU Local 500 Bargaining Unit Members
Office of Employee Engagement and Labor Relations (OEELR)
Employee and Retiree Service Center (ERSC)
MONTGOMERY COUNTY PUBLIC SCHOOLS (MCPS)
Rockville, Maryland 20850
See MCPS Regulation GMG-RA, Tuition Reimbursement
MCPS Form 442-1
December 2021
Page 1 of 2
CLEAR FORM
PAPER WORK SUBMISSIONS
Applications that are incomplete, missing documentation, or unsigned will not be processed and will be
returned to employee.
Select one submission option only:
o email a PDF of the signed form and all required documentation to ERSC@mcpsmd.org
o fax the signed form and all required documentation to 301-279-3651 or 301-279-3642.
EMPLOYEE INFORMATION
Employee Name _______________________________________________________________________________________________
(Maiden or former name if applicable): _________________________________________________________________________
MCPS Employee ID:_______________ Hire date at MCPS ____/____/_____ Telephone: Primary _____-_____-______ Cell _____-_____-______
Bargaining Unit: _______________________________________________________________ (SEIU Bargaining Unit Members Only)
Address: ______________________________________________________________________________________________________
______________________________________________________________________________________________________________
EDUCATION
Where did you receive your education? (Please include as many schools as apply)
What was the topic of study? ________________________________________________________________________________
*Please attach an official transcript for each school attended. (An official copy of the transcript is acceptable)
STUDENT DEBT
Have you received debt relief assistance before from the Student Debt Relief Fund? o Yes o No
How much student debt (incurred prior to beginning work at MCPS*) did you owe in total when you were hired at
MCPS? (Please attach documentation about loan balance from the month of your hire________________________________)
*This question about how much debt was incurred before joining MCPS only applies to first time applicants.
What was your current student debt balance, as of December 31st of last year? ___________________________________
(Please attach documentation showing this balance)
Are you currently in good standing with all of your student loan services? o Yes o No
(Please attach a report from all of the applicable loans that shows you are in good standing.)
Have you attended the workshop on student debt relief? o Yes o No
EMPLOYEE SIGNATURE
I certify that all of the information I have provided on this form and in any accompanying document is true, complete, and
correct to the best of my knowledge and belief. I understand that my electronic submission of this form and my electronic
signature are intended to be, constitute, and are equivalent to my personal signature.
Employee’s Signature ____________________________________________________________________ Date ____/____/_____
FOR OFFICIAL USE ONLY:
Date of Receipt: ____/____/_____ Date of Processing: ____/____/_____ Approve o Yes o No
Amount: ____________________ Date of disbursement: ____/____/_____
MCPS Form 442-1
Page 2 of 2
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Student Debt Relief Fund for SEIU Local 500 (Montgomery Schools)

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Completed 1 March 2022

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