The Benefits Program for Washington Post Companies

Tuition Reimbursement Form

Company: ____________________________ Location: __________________ SSN: ________________ Employee Name: _____________________________

Complete the following information:

_________________________________
Department

___________________________
Job Title

Name and Location of Educational Institution: ______________________________

______________________________ ______________________________ ______________________________

Courses:
Course Number Name of Course

Course Level Undergraduate or Graduate**

Begin Date

End Date

Tuition

U U U

G G G

$ $ $ Mandatory Fees* $ Total Cost $

*Explain: _______________________________________________________ Does the course relate to your present job? Explain: ___________________________

______________________________________________________________
Are you enrolled in a degree program? Yes No Date Expected: ___________ If yes, degree sought: ________________________

____________________________________
Employee Signature

Date Date Date

____________ ____________ ____________

____________________________________
Supervisor Signature

____________________________________
Benefits Representative Signature

See second page for important information on tuition reimbursement requests.

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The Benefits Program for Washington Post Companies

Tuition Reimbursement Form

Benefits
This plan encourages you to further your education by reimbursing you for the cost of tuition for any eligible course(s) which you successfully complete.

Courses in a graduate degree program provided the degree is relevant to your position with the Company; Other courses that will enhance your ability to make contributions in your current job.

Benefit Maximum
The maximum tuition reimbursement is $2,500 per calendar year. You must be employed by your participating company at both registration and completion of the course(s).

Eligibility
The Tuition Reimbursement Plan covers all full-time employees who are participants in The Benefits Program for Washington Post Companies.

**Tax Implications Accepted Schools

Accredited colleges, universities, vocational and technical schools. Tuition reimbursement may represent taxable income to you, and taxes may be withheld from your payment. Payments received by an employee for undergraduate tuition, fees, books, supplies, etc., under this plan may be excluded (code section 127) from gross income up to the maximum benefit of $2,500. The exclusion applies with respect to undergraduate level courses only. It does not apply to graduate level courses. Currently, this means that all graduate tuition reimbursements will represent taxable income to you and appropriate taxes will be deducted from your tuition reimbursement. These provisions are subject to changes in the tax law. Any payment will be subject to the law in effect when reimbursement is made.

Course Eligibility
Approved courses are those that are approved in advance by your supervisor and your Benefits Representative. Generally, courses will be approved if they are offered by a recognized educational institution and if they meet these criteria:
l

Reimbursement Procedure
l

Complete this Tuition Reimbursement Form and receive approval prior to registering for course(s) . Upon completion of course, present paid receipt (or canceled check) and proof of satisfactory completion to your Benefits Representative.

Academic or vocational courses related to your current job; Courses necessary to complete work toward an undergraduate degree or a high school diploma;

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