Forms for Staff
Forms for Staff
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403b Agreement - Must return to Business Office
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403b Board Approved Vendor List
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Direct Deposit Form
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Flexible Spending - Daycare Claim Form
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Flexible Spending - Health Care Claim Form
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Flexible Spending Brochure
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Flexible Spending Enrollment Form
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HIPPA Privacy Authorization
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Requisition Form - Grant
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Requisition Form - Standard
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Tax - Federal Withholding W-4 Form 2023
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Tax - State Withholding W-4 Form Illinois
Omni Inside Edge Newsletter
403(b) Information
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Considering (Optional) Tax-sheltered Benefit for 2020?
- Per IRS regulations, 403(b) Plan Participation at CHS D94 is open to all wage earners; except, students performing services for the District, employees who work less than 20 hours per week, employees whose annual contribution would be $200, or less, and nonresident aliens.
- 403(b) participation is governed by the District 94 Plan Document designed in accordance with IRS Code for Tax-Sheltered Annuities. It allows for enrollment and participation to begin when District 94 employment commences; and, at other times during the year: the first payday in anuary, the first payday in July, and the first payday in any other month that you choose to enroll.
- If you currently contribute to a 403(b) Plan, re-enrollment is NOT required for 2020. Current (2019) plan participation will roll into the new (2020) calendar year.
- Changes for Plan Participants may be made for 2020. Must submit an updated form.
- Discontinuation is effective at any time, if necessary. Must submit an updated form.
- 2020 Plan Notice. Universal Notice
- 403(b) Form for participation in a TSA SRA.
- Board Approved 403(b) Vendor List.
- Instructions for Initial participation, changes, and discontinuation for a 403(b) TSA Salary Reduction Agreement (SRA), and Misc. Plan Transactions.
- The Maximum Contribution Level for participants under age 50 is $19,000.
- The Maximum Contribution level for participants age 50 or older is $25,000.
- 403(b) SRA Forms for January 15, 2020 are due in the Business Office by 12-20-19.
Account Related Misc. Plan Transactions
For questions, please contact Chris Olsen at (630) 876-6223 or email colsen@d94.org.
403(b) TSA SRA Form for Current Contributors to make Optional Changes in 2020
Please see the 403(b) TSA SRA form, if you are currently contributing to a Tax-sheltered Annuity and wish to make changes for Calendar Year 2020.
- Under Age 50 Maximum Contribution Limit for 2020 is $19,500
- Age 50(+) Maximum Contribution Limit for 2020 is $26,000
Please return forms to Chris Olsen in the Business Office. Changes are effective with the first payroll of the month, after the form is received.