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Employee Forms



Accounting/Payroll Forms


403b Annuity TSA Salary Reduction Agreement (link)

403b Annuity Salary Reduction Agreement. Form to be completed with financial adviser and submitted to the Accounting Department, Hughes Educational Center.

W-4 Form - Employee's Withholding Allowance Certificate (link)

Complete Form W-4, sign and submit to the BPS Accounting Department, Hughes Educational Center.


YMCA Membership Information (link)

For pricing and membership information visit the YMCA web site.

2016-17 Pay Day Schedule (lsx document)
File Size: 23.24 kb

Adjusting Journal Entry (lsx document)
File Size: 19 kb

Bulk Mailing (lsx document)
File Size: 23.2 kb

Please complete the Bulk Mailing Postage form for all mailing projects using the district mailing permit. Form must be attached to the bulk mailing that is sent to HEC and a copy must be sent to accounting.

Commute Form (lsx document)
File Size: 34.1 kb

This form must be be filled out online. Enter information, print, sign, obtain supervisor signature, and submit to the Business Manager. Commute forms should only be submitted at the end of the school year. Commutes will only be reimbursed in May of each year unless the commute is only in effect during the first semester of the school year.

Deposit Ticket (lsx document)
File Size: 16.76 kb

Complete the attached deposit ticket for all cash and check deposits and submit to the accounting department in a zippered bank bag.

Direct Deposit Authorization Form (lsx document)
File Size: 18.45 kb

Bismarck Public Schools requires direct deposit for employee paychecks. As an added feature the check may be deposited into more than one account (checking, savings, or any combination).To enroll, simply complete the authorization below, attach a blank, voided check or bank letter for Each account, and return it to the BPS Accounting Department, Hughes Educational Center.

Interpreter Payment (pdf document)
File Size: 450.67 kb

Hourly Staff Time Sheets 16-17 (lsx document)
File Size: 169.15 kb

This form can be filled out online and saved on a computer. Enter information online, print, sign, obtain supervisor signature, and submit to the BPS Accounting Department, Hughes Educational Center. Document contains time sheets for the entire year.

In-District Mileage Voucher (xls document)
File Size: 62 kb

This form can now be filled out online and saved on a computer. Enter information online, print, sign, obtain supervisor signature, and submit to the Accounting Department. Please note the mileage rate changes in January of each year. Mileage for January to June must be submitted by July 8th and mileage for July to December must be submitted in January. Applies to exact miles/trip.

Mileage Chart (pdf document)
File Size: 39.97 kb

Payment Voucher Form (xls document)
File Size: 40 kb

Vendor payment voucher form. This form can be filled out online and saved on a computer. Enter information online, print, sign, and submit to the BPS Accounting Department, Hughes Educational Center.

Salary Staff Time Sheets 16-17 (lsx document)
File Size: 147.98 kb

This form can be filled out online and saved on a computer. Enter information online, print, sign, obtain supervisor signature, and submit to the BPS Accounting Department, Hughes Educational Center. Document contains time sheets for the entire year.

Staff Compensation - Misc Payment (lsx document)
File Size: 56.71 kb

The Staff Compensation Form should be used for miscellaneous payments i.e., tour duty, speech judge, etc. The form should be completed, signed, approved and submitted to the BPS Accounting Department, Hughes Educational Center.

Staff Development Compensation Prior Approval Form (xls document)
File Size: 35.5 kb

Document includes the Staff Development Preparation and Presentation Time Log Request for Payment.

Summer School Teacher Absence/Substitute Form (lsx document)
File Size: 30.01 kb

This form should only be used to submit SUMMER SCHOOL absences. This form can now be filled out online and saved on a computer. Enter information online, print, sign, obtain supervisor signature, and submit to the BPS Accounting Department, Hughes Educational Center.



TFFR - ND Teachers Fund for Retirement Forms


TFFR Member Action Form (pdf document)
File Size: 125.63 kb

SFN 50981 (pdf). New and returning TFFR members are required to complete and sign a Member Action Form to properly enroll in the TFFR plan. Active, inactive and retired members who have TFFR service credit on July 1, 2008 are Tier 1 members. New members and returning refunded members employed on or after July 1, 2008 are Tier 2 members

TFFR Change of Name/Address (pdf document)
File Size: 71.96 kb

SFN 50070 (pdf). ND TFFR Retirement & Investment Form for change of personal information.

TFFR Designation of Beneficiary (pdf document)
File Size: 169.01 kb

SFN 10341 (pdf). ND TFFR Retirement & Investment Form for designation of beneficiary. TFFR members should designate a beneficiary(ies) in writing for the purpose of directing payment of a claim due to a member's death.

TFFR Notice of Termination (pdf document)
File Size: 73.09 kb

SFN 17144 (pdf). ND TFFR Retirement & Investment Form for notice of termination of employment.

TFFR Retired Member Employment Notification (pdf document)
File Size: 120.21 kb

SFN 52161 (pdf). A retiree may return to TFFR covered employment under certain employment limitations. The limits apply to TFFR covered employment which includes teaching, supervisory, and administrative services in a ND public school or state institution covered by TFFR except for extracurricular duties and professional development. The employer and retiree are required to notify TFFR in writing within 30 days of the retiree's employment. Notification must be made each year the retiree is employed. Failure to notify TFFR will result in the loss of one month's annuity benefit for the retiree and $250 penalty to the employer.



PERS - ND Public Employees Retirement System


PERS - Designation of Beneficiary for Group Retirement (pdf document)
File Size: 235.47 kb

This "Designation of Beneficiary" is for the group Retirement Plan only. To designate beneficiary (ies) for the group Life Insurance Plan, please complete a "Life Designation of Beneficiary Change SFN 53855"

PERS Notice of Change - Membership Data Record  (pdf document)
File Size: 71.96 kb

NDPERS Retirement form for change of personal information.



Employee Forms


Club Goal Information Sheet (pdf document)
File Size: 203.71 kb

Grant Process Form - Authorization to Write a Grant (pdf document)
File Size: 61.99 kb

Grant Royalty Payment Form (pdf document)
File Size: 59.6 kb

Instructional Planning (pdf document)
File Size: 194.42 kb

Intervention Fidelity Check (pdf document)
File Size: 71.92 kb

Meeting-Activity Sheet (pdf document)
File Size: 106.31 kb

Meeting Summary Form A (doc document)
File Size: 28 kb

*Note: This form is designed to be filled out online and then printed.

Meeting Summary Form B (doc document)
File Size: 22.5 kb

*Note: This form is designed to be printed and then filled out by hand.

New Club Request Form (pdf document)
File Size: 290.69 kb

Permission to Request Information (pdf document)
File Size: 78.36 kb

Permission request form to have access to information.

Problem Solving Process Summary (pdf document)
File Size: 114.63 kb

Record of Access and Inspection  (pdf document)
File Size: 52.7 kb

File access and inspection requirements: BPS "school officials with legitimate educational interests" in accessing this student's education records do not need to complete this section of the form. All other individuals not meeting such criteria must document access/inspection below. Parents and eligible students are encouraged to document access/inspection as a matter of school record.

Release of Information (pdf document)
File Size: 65.79 kb

Mutual exchange of information form between the Bismarck Public Schools and another person or agency.

Request for Assistance (pdf document)
File Size: 114.68 kb

Request for Instructional Aide Services (doc document)
File Size: 61.5 kb

Bismarck Public Schools request for instructional assistant services. Send request forms to the Elementary Assistant Superintendent, Hughes Educational Center.

Student Background Review (pdf document)
File Size: 161.83 kb

Teacher Grievance Form (doc document)
File Size: 27.5 kb

Teachers should use this form if they would like to file a grievance as defined in the Negoatiated Agreement.

Transcript Release Form (pdf document)
File Size: 108.4 kb

Use this form to authorize release of student transcript information. Advance payment of $2.00 per transcript is required.


Employee forms links


Fundraiser Approval Form (link)

This form must be submitted prior to all district/building fundraising events.

Restraint or Seclusion Form (link)

Club Goal Information Sheet (pdf document)
File Size: 203.71 kb

Meeting-Activity Sheet (pdf document)
File Size: 106.31 kb


Travel Authorization Process


There are two parts to approval. 1st complete the travel rationale online and print it. 2nd attach it to a your Travel Authorization form. Both must be given (in paper format) to your supervisor for approval.

The forms must be completed BEFORE and in sufficient time to obtain approval prior to incurring any travel expenses. If approved, the Travel Authorization form is returned to the originator for completion of the Travel Expense Voucher (lower portion of form). Upon return from trip, fill out Travel Expense Voucher (bottom portion); submit along with required receipts to the Business Office for reimbursement.

Out of State Meal Allowance Rates (link)

To look up domestic per diem rates throughout the continental United States (CONUS), select a year and click on a state.

Travel Rationale Form (link)

Out of District Travel requires a two part process. First complete the Travel Rational Form and then complete the Expense Authorization form. Both forms must be submitted to your supervisor for approval.

Travel Authorization (pdf document)
File Size: 397.95 kb


Leave Request Forms


Leave Request Forms


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