Taxability_Grad_Revised Policy_August 2010.doc
Taxability Determination Form
For Employee Graduate-Level Tuition Remission Benefit
Employee Name: ___________________________________ Title: _____________________________
Supervisor Name: ___________________________________ Title: _____________________________
Degree Program of Study: _______________________________________________________________
Starting Semester: Fall 20______ Spring 20____ Summer 20______
Attach a brief description (2-3 sentences) of your Program of Study to this form and submit both to
your supervisor. A copy of the completed form will be returned to you within 10 business days of
submission to HR.
I have read the summary of the IRS regulations on the back of this form concerning taxation of tuition
remission payments. I understand that in conjunction with my supervisor, HR and the Treasurer’s
office will determine if my tuition remission payments will be reported for taxation to Payroll based on
the information submitted below. I further understand that if my program of study should change I
must fill out a new Taxability Determination Form at that time.
Employee Signature____________________________________ Date _________________________
Section to be completed by Supervisor
Your staff member will be taking graduate-level coursework. Please answer the questions below regarding the
taxability of graduate-level coursework and sign verifying the chosen coursework of study and these
descriptions. Submit the completed form and program description to the Human Resources office for review.
Under current IRS regulations for graduate level tuition reimbursement benefits (a Tuition Reduction Program); a
determination must be made concerning taxability, based on the criterion below.
(Note: You may refer to the back side of this memo for a longer description of tuition reimbursement benefit taxation
according to IRS regulations effective January 1, 2002)
1. Is the graduate degree program required by either Pitzer or law to keep the employee’s present salary,
status, or job? Yes____ No_____
2. Is the graduate degree program directly related to the employee’s current position? Yes____ No_____
3. Is the graduate degree program being undertaken for the purpose of maintaining and improving the
skills required for the current job? Yes____ No_____
4. Is the employee a graduate student who teaches or performs research activities at Pitzer? Yes____
5. Does the graduate degree qualify the employee for a new trade or business? Yes____ No_____
Supervisor’s signature verifying the information above:
Supervisor: ____________________________________ Date: ____________________