

Ages 13-15
The New England Work
and Family Committee understand the difficulties families face when school is
out for vacation. We want to ease your financial obligation during school vacations and reimburse for school vacation
weeks.
The Teen
School Vacation Program is for February April and December school vacations.
This program is to enrich your teen child/ren (ages 13-15). The New England Work and Family Committee
will reimburse up to $200.00 per week up to 3 weeks annually for school
vacations. We will reimburse for day or
overnight activity/ programs. The
monies you are reimbursed are taxable.
·
You must be a member of
IBEW, management or non-bargained from MA, RI, VT, NH or ME.
·
CWA , IBEW 2213, VIS and
Idearc employees are not eligible
for this program
·
You must have a total
household income less than $125,000 for year 2006 for December 07 submission.
·
You must have a total
household income less than $125,000 for year 2006 for February 08 and March 08submission.
·
You must have a total
household income less than $125,000 for year 2007 for April 08 and December 08 submission
·
The program is for your
dependents ages 13-15 listed on your
tax return
·
You must have incurred activities/
program expenses during school vacation weeks.
·
Program contingent on
contract negotiations
Activities/
Program provider must be a day camp program that has a tax identification
number.
Some
activity/programs that are included
are: academic, adventure , arts ,
sports activities/ programs and YMCA, 4H or Boys/Girls Club or recreational
sponsored programs .
You
can obtain an application by going to www.verizon.com/life
and click on union member resources, select New England Work and Family. You
can call 617-743-6310 or call your union representative.
·
Complete the application
in full (one application per dependent)
·
Have activity/ program director/
administrative office sign the application after the activity/ program, week is
completed.
·
Signatures must be original.
·
Attach receipts or
canceled checks to the application
·
Send your 2006/2007 1040
federal tax return (dependents name must be on your tax return)
·
If your child’s is name
is not on your tax return because of a recent adoption, please attach
documentation.
·
Send 2006/2007 employee
W2 (must be a Verizon employee).
·
You submit the
application after the activity/ program has been attended
You
may be reimbursed up to $200 per week for February/March and April December school
vacation weeks.
Complete
the application and return along with your 2006 federal tax return and W2 for
December 07 and February 08 submission. Send your 2007 federal tax return, W2
for March- December 08 submission along with receipts for the activity/ program.
The application must be received no later than:
For
December 07 by January, 11, 2008
For
February 08 vacation by March 14, 2008
For
March 08 or April 08 by May 9, 2008
December
08 by January 09, 2009
Your
reimbursement will be included your paycheck the last Thursday of the month.
If
you need help locating a program you can call VZ-LIFE at 1800-845-0632.
This is a taxable Teen School Vacation Reimbursement
Program
IBEW/Verizon New England Work and Family Committee
Teen School Vacation
Program
Taxable Reimbursement Program ages
13-15
Complete ALL information. Your
application WILL BE RETURNED if any information is missing. Please print
clearly or type.
|
Employee Name |
|
Social Security
Number |
|
Home Address |
|
City State Zip Code |
|
Home Phone |
|
Work Address |
|
City State
Zip Code |
|
Work Phone |
|
Cell phone Email |
|
IBEW Management
Non Bargained |
|
What union local |
|
1) Dependent Full Name DOB Age |
|
Provider/Program
Full Name |
|
Tax ID Number |
|
Provider’s
Address |
|
Provider’s Phone
Number |
|
Indicitate date attended, and cost of
activity next each week |
|
Week 1 |
|
Week 2 |
|
Week 3 |
|
Providers/Director/Administrative
office Signature |
You MUST attach a copy of
your 1040 and W2 for year 2006 if submitting for December 07 and February 2008. Attach 2007 tax return and W2 if submitting
for March, April and December 08 and submit receipts and/or cancelled checks before sending.
Only applications returned with canceled checks or receipts will be
paid.
Employee Authorization:
I,(Print Name)
________________________________________ am requesting reimbursement for the
expenses listed above. I have read the criteria of the Teen School Vacation Activity/
Program and agree to abide by them and my signature signifies I abided by the
criteria. I certify that all the information I have provided on this form and
in the attachments is accurate.
Employee Signature
|
Send this
form and attachments to:
Verizon/ IBEW
Attn: New England Work
& Family Committee
15 Chestnut St floor 3
Worcester, MA 01609