TUITION REMISSION AUTHORIZATION FORM
TUITION REMISSION AUTHORIZATION FORM
TUITION REMISSION AUTHORIZATION FORM
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<strong>TUITION</strong> <strong>REMISSION</strong> <strong>AUTHORIZATION</strong> <strong>FORM</strong><br />
Admissions process completed? Yes No<br />
Return this completed form to Human Resource Services by the last day of regular registration (not late<br />
registration).<br />
Name: last, first (please print)<br />
EMPLOYEE IN<strong>FORM</strong>ATION<br />
Name: last, first (please print)<br />
STUDENT IN<strong>FORM</strong>ATION<br />
_________________________________________________________ _____________________________________________________<br />
Department or office:<br />
Normal working hours:<br />
Date of hire:<br />
MU ID Number:<br />
Relationship to employee: MU ID Number:<br />
Self Spouse<br />
Dependent Child<br />
Non-Dependent Child<br />
Child tax status (if benefit is for child):<br />
New registration: credits<br />
Dropping: credits Adding: credits<br />
Requested by:<br />
(Signature)<br />
Yes (student is claimed as dependent for tax purposes)<br />
No (student is not claimed as dependent for tax purposes)<br />
Program:<br />
Program:<br />
Undergraduate<br />
Full-time<br />
Graduate<br />
Part-time<br />
Date:<br />
Term: _____<br />
Year: _____<br />
<strong>AUTHORIZATION</strong><br />
Classes scheduled during work hours (Y/N)? ________<br />
Plan for make up time approved (Y/N)?<br />
Department supervisor name (please print)<br />
_______________________________________________________<br />
Department supervisor signature<br />
_______________________________________________________<br />
Vice President Signature<br />
Date<br />
___________________________________<br />
Date<br />
Date<br />
Do not write below line, for official use only<br />
y:<br />
HR SERVICES<br />
REGISTRAR<br />
STUDENT ACCOUNTS<br />
Number of credit hours authorized<br />
for remission:<br />
Number of credit hours to be taken:<br />
Invoice number<br />
Amount<br />
Tuition rate:<br />
Full tuition credit<br />
<br />
% discount: _______<br />
Tuition is subject to applicable<br />
taxes if the tuition is for a<br />
non-dependent child.<br />
Tuition amt. subject to taxes: $_______<br />
Received by: Initial Date<br />
Financial Aid ________ ________ TAG _______ FAF _______<br />
HR Services ________ ________<br />
Registrar ________ ________<br />
Student Accounts ________ ________<br />
10/2001
INSTRUCTIONS FOR COMPLETING AND PROCESSING<br />
THE <strong>TUITION</strong> <strong>REMISSION</strong> <strong>AUTHORIZATION</strong> <strong>FORM</strong><br />
STEP 1 Employee:<br />
1 . You must complete the Admissions process before applying for this benefit.<br />
2 . Obtain a Tuition Remission Authorization Form from the Human Resource Services Office.<br />
3 . Complete all the information on the reverse side of this form.<br />
4 . Employees’ spouses and dependent children who intend to study full-time must apply for<br />
federal and state financial aid through the usual Financial Aid process. Visit the Financial<br />
Aid Office for additional information.<br />
STEP 2 Supervisor:<br />
1 . Verify that the employee has been employed for the required amount of time and meets all<br />
the requirements in the appropriate Employment Manual.<br />
2 . Authorize the form and make a copy for your records.<br />
STEP 3 Employee:<br />
Return this completed form to the Human Resource Services Office by the last day of<br />
regular registration (not late registration).<br />
STEP 4 Human Resource Services Office:<br />
1 . Verify that the required waiting period has been met and record the number of credits authorized<br />
for tuition remission.<br />
2 . Determine if the tuition remission is subject to applicable taxes. Employees’ whose children<br />
are not dependents for tax purposes are subject to taxes. Make an additional copy of the<br />
Tuition remission forms that need to be taxed and submit the copies to the Benefits Manager<br />
for processing in the computer. Request from Student Accounts the amounts subject<br />
to taxes.<br />
3 . On the last day of regular registration (not late registration), take a copy of all tuition remission<br />
forms to the Student Accounts Office.<br />
4 . File original tuition remission forms in the Human Resource Services Office.<br />
STEP 6<br />
Read your employment manual for additional information about this employment benefit.<br />
10/2001