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Herscher CUSD #2

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Staff Forms



Welcome to our staff forms page

When submitting any of the following documents, please remember to keep a copy for yourself.

 

Purchase Order Information
Purchasing and Cash Handling Procedures
New Vendor Request Form (Obtain and attach their W9 form)
BLANK W9 (Need from new vendors. Return to UO)Inserted Image
Our Tax Exempt Letter
Our W9 Form (2016)
School Specialty Order Instructions
Staples Order Instructions
Request for Purchase Order (2020)
Check Request (2020)
American Express P-Card Expense Report (2020)
BMO Mastercard P-Card Expense Report (2020)

Questions regarding purchase orders can be directed to Kristin in Accounts Payable at 815-426-2162 or via email at milligank@hcusd2.org 


Insurance Information / Documents

The Herscher School District is part of the Educational Benefit Cooperative (EBC).

EBC Summary for 2022-2023

OPEN ENROLLMENT for 2023-2024 is closed.

Should you experience a qualifying life event, please contact Payroll/HR at 815-421-5016

Online Enrollment Guide

EBC MyCHoice Mobile App - NEW! 

23-24 Insurance Rates

EBC Summary for 2023-2024
 

DENTAL
BCBS Dental Benefits Highlight Sheet  - LOW Plan
Dental Low Policy Document
BCBS Dental Benefits Highlight Sheet- HIGH Plan
Dental High Policy Document

HEALTH
HSA PPO Summary of Benefits and Coverage (SBC) 23.24
HSA PPO Guide
HSA Frequently Asked Questions
HSA PPO Handout
HSA Salary Reduction Agreement 2024
Questions about allowable expenses under the HSA? Click here for a helpful website. 

HRA PPO Summary of Benefits and Coverage (SBC) 23.24
HRA PPO Handout
HRA Deductible Reimbursement Form * Send w/ your EOB that states the amount met of your deductible to the Unit Office Attn: H. Crane
**The district does not reimburse Out-Of-Pocket expenses.**

Insurance Waiver 23-24
Transparency in Coverage

LIFE
Voluntary Life and Accidental Death & Dismemberment (AD&D) Plan Highlights  
Reliance Voluntary Life Rates 
Reliance Voluntary Accidental Death and Dismemberment (AD&D) Rates 

VISION
EyeMed Benefits Sheet
EyeMed Out-Of-Network Claim Form for mailing 

EMPLOYEE ASSISTANCE PROGRAM
Handout 
Identify Theft Brochure
Travel Assistance Flyer

MANDATED NOTICES
Women's Health and Cancer Rights Notice
CHIPRA State Premium Assistance Notice
Title IX Information


Payroll/Human Resources Documents
2023-2024 Pay Days
403b Meaning Notice 2024
Plan Participation Guide 2024 
Annual Retirement Benefit Guide 2024
403b Salary Reduction Agreement 2024
403b ROTH Salary Reduction Agreement 2024
457b Salary Reduction Agreement 2024 
403b Investment Website
409-A Annualized Compensation Form (CERT)
Application Signature Page
AUP Acceptable Use Policy 

Bookkeeping/Payroll Form Instructions
DCFS Mandated Reporter Acknowledgment Form 
Direct Deposit Form/Instructions
Drug and Alcohol-Free Workplace. Board Policy 5:50
Employee Information Form - Use to update personal information with UO
Employee - First Report of Injury Form/Instructions 
Extra Pay Sheet (CERT) Music Dept ONLY 
Extra Pay Sheet (CERT) Not Music Dept NEW/UPDATED for 2023-2024SY
Extra Pay Sheet (NON-CERT) NEW/UPDATED for 2023-2024 SY
Fingerprint Form - All Staff  - - - EXCEPT bus drivers
Fingerprint Form - Bus Drivers ONLY! 
Harassment and Sexual Misconduct Policy

IDES new hire reporting form
I-9 Form and Instructions - updated 8/2023
IMRF Voluntary Additional Contribution Make/Change Form

Employer Cost & Participation Information (IMRF): https://www.imrf.org/en/about-imrf/transparency/employer-cost-and-participation-information
Non-Certified Staff. Irrevocable Notice of Intent to Retire. 2023-2028
Personal Day Request Form
Personnel Recommendation Form - PDF - - - USE AFTER JULY 1, 2023 
Personnel Recommendation Form - WORD - - - USE AFTER JULY 1, 2023 
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Physical Exam Form
Standards and Procedures for Staff
Statement Concerning Employment in a Job Not Covered by Social Security

W-4 Illinois
W-4 Federal (2024)
     Click here to view latest tax tables.
     Click here to view 2024 method percentages for automated payroll systems
         Questions about your federal withholding?  Click here for some information

Contract Links
PERA Overview  
PERA Public Acts  
FMLA

Miscellaneous Forms
AUP - Acceptable Use Policy - Internet Access
Bloodborne Pathogen Policy
Computer Purchase Program 23-24
Extra Trip Request Form
Field Trip Policy/Forms (NEW) (PDF)
Field Trip Policy/Forms (NEW) (WORD)
HHS Overnight Trip Form
Mileage Reimbursement (eff. 1.1.2024)
Proof of Residency Form
Safety Handbook for Staff
Student Transfer Form
SUB Teacher Time Report
Tenure and RIF Processes
Transportation Request Form
Travel Request / Expense Report (2024)
Tuition Reimbursement Form and Info
Tutoring Reimbursement Form
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Technology Department
Accessing public folders/calendars using the web
Accessing public folders/calendars using Outlook
Connecting Android devices to e-mail server
Connecting iPads and iPhones to e-mail server
Connecting your personal laptop to school email using Microsoft Outlook
Google Apps for education sign in  
Link to Technology Help Desk
New online e-mail link
Setting up your web-page
Teacher Webpage Tutorial Video
Teacher/Staff request to your add personal device on wireless

Maintenance Request Forms
Activity and Facility Usage Request Form
BGS Maintenance Request Form
Custodial Request Form
Foods Maintenance Request Form
HHS Maintenance Request Form
HIS Maintenance Request Form
LMS North Maintenance Request Form
LMS South Maintenance Request Form
Special Services Maintenance Request Form
Technology Maintenance Request Form
Transportation Maintenance Request Form

Food Service Department

Lunch Count Form: https://forms.gle/ftGeXuEoi8BurxEeA