Tuition Reimbursement Procedures, Request and Repayment Agreement
Procedures:
• Read the Tuition Reimbursement Policy on USBnet or www.USBankHR.com carefully, including all of the provisions and restrictions that may apply to you. The Tuition Reimbursement policy that applies is the policy version in effect at the start of the course. Complete the attached Tuition Reimbursement Request and Repayment Agreement form and have it approved by your manager before you enroll in the course. (Please note that only the Program Administrator may make exceptions to the rules and procedures listed within the policy.) Retain the completed forms until the course is completed. This is a two-page form – please complete and sign both pages. Enroll, pay the tuition and complete the course. Approved reimbursements will be deposited, along with your regular pay, into your employee bank account if you have direct deposit of pay. If you do not have direct deposit, the reimbursement will be included in the paycheck that you receive. Reimbursement will generally occur within 30 days or two pay periods following submission of all of the appropriate paperwork
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Steps to complete request: o Ensure that you have a copy of both the statement/receipt reflecting the amount of the tuition paid (such as a tuition statement showing tuition cost less fees, or receipt of payment for tuition) and a copy of your unofficial or official grade report showing that you have satisfactorily completed the course. If you are taking online classes, your name and school ID must be shown on the grade report. o Submit your signed and approved Tuition Reimbursement Request and Repayment Agreement, your statement/receipt reflecting the amount of the tuition paid (such as a tuition statement or receipt of payment for tuition)showing the cost of tuition less fees and your grade report to Tuition Reimbursement at MK-WI-J2S or fax to 414-765-6545. Any additional paperwork that may affect the amount to be reimbursed (i.e. grants, scholarships, stipends GI bill, etc.) should accompany the paperwork. Completed paperwork should be submitted within 90 days of course completion.
Tuition Reimbursement Check list 1. Complete the Tuition Reimbursement request form and Tuition Reimbursement request and repayment agreement, prior to beginning your class. 2. Have you manager complete Part Two of the Tuition Reimbursement Request form. All questions must be answered Yes or No. 3. Complete your class earning a grade of C- or higher. 4. Submit these four items To: Tuition Reimbursement Dept. @ 414-765-6545 or MK-WI-J2S – your tuition reimbursement request form – repayment agreement – copy of your schools billing statement, minus fees – proof of passing grade to tuition
NOTE: Do not submit your original paper work via interoffice mail if you have faxed your paperwork to the Tuition Department. NOTE: Incomplete requests will be returned to sender. Nothing will be retained by the Tuition Reimbursement Dept.
TUITION REIMBURSEMENT REQUEST AND REPAYMENT AGREEMENT
This Agreement is made by _____________________________________ (“Employee”), Employee understands and agrees to the following: 1. U.S. Bank (“Employer”) will reimburse, upon successful completion of eligible courses taken at an accredited college or university, 75 percent of tuition costs, up to the following amounts: (1) for eligible courses applied to a graduate degree program, up to $5,250 of tuition costs Jan. 1 – Dec. 31 of the current year, and (2) for all other eligible courses, up to $3,000 Jan. 1 – Dec. 31 of the current year. Employee agrees to complete a Tuition Reimbursement Request and Repayment Form, signed and approved by his or her manager, prior to enrolling in the course. Employee will retain form and submit upon completion of the course. Employee agrees to provide Employer with a copy of the statement/receipt reflecting the amount of the tuition paid (such as a tuition statement or receipt of payment for tuition) from the school and grade report within 90 days of completion of each course. (Tuition cost less fees.) Employee agrees that if he or she (1) does not complete a course, (2) receives a final grade lower than a “C-” in a course (lower than 2.0 on a numeric scale) or otherwise unsatisfactory score if not measured by a grade or a number (such as pass/fail), (3) resigns or gives notice of resignation of his or her employment before reimbursement is made, or (4) is terminated for any reason except for job elimination where Employee is severance-eligible under a U.S. Bancorp severance plan, he or she becomes ineligible for reimbursement, even if approval was previously provided. In cases of job elimination with severance eligibility, Employee may complete courses outstanding at the time of position elimination, but is ineligible to be reimbursed for courses enrolled in after he or she has received notice of job elimination. Employee agrees that if he or she receives an overall performance rating below a “3,” or receives corrective action for performance, the employee becomes ineligible for reimbursement. Employee may complete courses outstanding at the time of the unsatisfactory performance rating, but is ineligible to be reimbursed for courses enrolled in after he or she received this performance rating or corrective action. Employee will remain ineligible for reimbursement unless and until Employee receives an overall performance rating of “3” or better or resolves any stated performance issues. If Employee voluntarily leaves or is involuntarily terminated for reasons other than job elimination, Employee agrees to repay to Employer the full amount of any reimbursement received within one year of the termination date, including tuition for courses applied to a graduate degree program. In addition, the employee agrees to repay 50 percent of any reimbursement received within two years of the termination date for courses applied to a graduate degree program. To the extent allowed by applicable law, Employee authorizes payroll deductions of the amount owed Employer under the above-stated provisions, should payback be due. To the extent that the payback is not accomplished through payroll deductions, Employee shall remit the balance due prior to leaving the organization. If the Employee does not make full repayment required under this Agreement, and Employer resorts to litigation to obtain such repayment, Employee will be liable to Employer for all of Employer’s litigation costs and expenses, including attorneys’ fees, unless Employer does not prevail in such litigation. This Agreement is not an employment contract. Nothing in this Agreement is intended to alter Employee’s status as an at-will employee.
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10. All provisions of the U.S. Bank Tuition Reimbursement Policy not specifically contained in this Agreement shall apply. The Tuition Reimbursement policy that applies is the policy version in effect at the start of the course. Employee Signature: ______________________________________ _________ Date: ____________ 2/2008
TUITION REIMBURSEMENT REQUEST
Please Print
PART ONE -- COMPLETED BY EMPLOYEE AND SUBMITTED TO MANAGER PRIOR TO ENROLLING
LAST NAME COST CENTER MAIL CODE DAYTIME PHONE DATE OF HIRE FIRST MIDDLE EE ID # INTRANET ID
SCHOOL ATTENDING (Must be accredited)
BEGINNING DATE OF CLASS
ENDING DATE OF CLASS
SELECT ONE OF THE FOLLOWING. SEE POLICY FOR ANNUAL REIMBURSEMENT LIMITS.
DEGREE PROGRAM INFORMATION:
Undergraduate Degree Graduate Degree Individual course(s) or other program
Complete the degree program information:
Degree/major: Date admitted into program: School admitted:
LIST SOURCES AND AMOUNTS (Loans, grants, steipends,scholarships):
DID YOU RECEIVE OTHER FORMS OF TUITION ASSISTANCE?
No
COURSE TITLE
Yes: List total amount:
$
TUITION COST PAYROLL USE ONLY
I have read and understand the U. S. Bank Tuition Reimbursement Policy and Payback Agreement effective 1/1/2007, attached, and I am requesting reimbursement under the provisions of that policy. See Policy for annual reimbursement limits.
EMPLOYEE SIGNATURE
DATE
PART TWO -- APPROVED BY MANAGER PRIOR TO EMPLOYEE ENROLLING IN THE COURSE Answer all questions "yes" or "no"
1. *Is the employee currently on a corrective action plan for performance? 2. Is the employee currently "full-time" (classified on Payroll at 30 or greater hours)? 3. Was the overall rating on the employee's last performance review a "3," "2," or "1?" 4. Will the employee have six full months of employment by the time the course is scheduled to commence? 5. Is the coursework relevant to the employee's current assignment? 6. Is the coursework relevant to a position for which the employee is being trained? 7. Is the coursework applied to a specific business-related degree? 8. Is the coursework relevant to a written development plan established by the employee's manager? * Employees under a corrective action plan for performance are not eligible for reimbursement. Please do not submit this form for reimbursement.
MANAGER PRINT NAME LAST FIRST DAYTIME PHONE
Yes Yes Yes Yes Yes Yes Yes Yes
No No No No No No No No
I approve the tuition reimbursement request above. I have carefully screened any elective coursework taken under a degree program to ensure a reasonable degree of relevance.
MANAGER SIGNATURE
DATE
PART THREE -- AFTER COMPLETION OF COURSE
After completing course with a grade of "C-" or above (or equivalent), send this form along with grade report, statement/receipt and signed Payback Agreement, within 90 days of course completion, to: Tuition Reimbursement, MK-WI-J2S or fax to 414-765-6545.
Rev 2/2008