IBEW/ Verizon

New England Work and Family Committee

Summer Camp Program

Taxable Reimbursement Program

June 1- September 9, 2006 

 

 

Overnight Camp and Day Camp 

Summer Program  

 

 

IBEW/ Verizon

New England Work and Family Committee

Summer Camp Program

Taxable Reimbursement Program

 

The New England Work and Family Committee understands the difficulties families face when school is out for the summer.   We want to ease your financial obligation this summer and reimburse for summer camp/ day camp programs.      

 

The summer camp program runs from June 1 through September 9, 2006.  This program is to enrich your school age child/ren (ages 5-18).  The New England Work and Family Committee will reimburse up to $200.00 per week for a maximum of 4 weeks for the period identified above.  We will reimburse for overnight summer camps, day camps and summer programs. Your dependent can enjoy the outdoors, learn a skill, or participate in an athletic camp. The summer camp program is not daycare.  The monies you are reimbursed are taxable.

 

 

Eligibility Requirements

 

·                You must be a member of IBEW, management or non-bargained from MA, RI, VT, NH or ME.

·                CWA and IBEW 2213 are not eligible for this program

·                You must have a total household income less than $100,000 for year 2005

·                The program is for your dependents  ages 5-18 listed on your tax return

·                You must have incurred overnight camp or day camp expenses.

·                Maximum of 2 dependents per family

 

 

Camp Eligibility

 

Camp must be an overnight or day camp summer program that is licensed and /or has a tax identification number. 

Some camps that are included in the program are:  academic camps, adventure camps, arts camps, sports camps and traditional outdoor camps such as YMCA, 4H or Boys/Girls Club.

 

Family daycare, in home daycare, or programs normally covered by the Dependent Care Reimbursement Program are ineligible for The Summer Camp Reimbursement Program.  You may be eligible for the Dependent Care Reimbursement Program (DCRF).   

 

 

How do I apply?

 

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

If you have enrolled in more than one summer camp program, complete an application for each camp.

·                Have summer camp director/ administrative office sign the application after the camp session is completed.

·                Attach receipts or canceled checks to the application 

·                Send your 2005 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 2005 employee W2 (must be a Verizon employee). 

·                You submit the application after the camp  has been attended

 

How much am I reimbursed?

 

You may be reimbursed up to $200 per week for a maximum of 4 weeks during the summer from June 1 through September 9, 2006.

 

Complete the application and return along with your 2005 federal tax return, W2 and receipts for summer camp. The application must be received no later than September 30, 2006. Your reimbursement will be included your paycheck.

 

You can not claim reimbursement for both The Dependent Care Reimbursement Fund DCRF and the Summer Camp Program.

 

 

 

 

                     This is a taxable Summer Camp Reimbursement Program

 

 

IBEW/Verizon New England Work and Family Committee

2006 Summer Camp 

Taxable Reimbursement Program

 

Complete ALL information. Your application WILL BE RETURNED if any information is missing. Please print clearly or type.

Employee Name                                                          Social Security #
Home Address
City State Zip Code
Home Phone
Work Address
City                                                                                                     State                                                Zip Code
Work Phone                                      Cell Phone                                               Email
Check one                IBEW Local                                                    Management                              Non Bargained
List Each Dependent’s personal and provider information separately
1) Dependent Full Name                                                        DOB                                             Age
Type of Summer Care Reimbursement Request                  Summer Day Camp                  Summer Camp Over Night
Provider’s Full Name
Registration Number / License Number
Tax ID Number
Provider’s Address
Provider’s Phone Number
Indicate which week and how much for each week Week Ending Dates		Total Dollar Cost of Camp
JUNE	JULY	AUGUST	SEPTEMBER
6/10 $	7/1$	8/05 $	9/2 $
6/17 $	7/8 $	8/12 $	9/9 $
6/24$	7/15 $	8/19 $
	7/22 $	8/26 $
	7/29 $
Camp Director/Administrative office Signature
(Attach receipts and/or cancelled checks)
2) Dependent Full Name                                                           DOB                                               Age
Provider’s Full Name
Registration Number License Number
Tax ID Number
Provider’s Address
Provider’s Phone Number
Indicate which week and how much for each week Week Ending Dates		Total Dollar Cost of Camp
JUNE	JULY	AUGUST	SEPTEMBER
6/10 $	7/1$	8/12 $	9/2 $
6/17 $	7/8 $	8/19 $	9/9 $
6/24 $	7/15 $
	7/22 $
Camp Director/ Administrative Office Signature
(Attach receipts and/or cancelled checks)

You MUST attach a copy of your 1040 and W2 for year 2005, receipts and/or cancelled checks before sending. Only applications returned with cancelled 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 2006 Summer Camp 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

125 High St.

Boston, MA 02210

NO Later than September 30, 2006

 

To download PDF form click here