Blank Texas Ps 1040R PDF Form Get Texas Ps 1040R Here

Blank Texas Ps 1040R PDF Form

The Texas Ps 1040R form is a refund worksheet used by vocational programs approved by the Texas Workforce Commission (TWC). This form helps schools demonstrate compliance with state minimum cancellation and refund requirements. It is essential for schools to complete this form accurately to ensure that students receive the appropriate refunds based on their enrollment status.

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The Texas Ps 1040R form is a crucial document for vocational programs approved by the Texas Workforce Commission (TWC). It serves as a refund worksheet that ensures compliance with state regulations regarding cancellations and refunds. Schools must use this form to demonstrate that each refund aligns with the minimum requirements set by the state, even if their own policies are more generous. When a student withdraws from a program, this form helps schools calculate the appropriate refund amount based on various factors, such as the timing of the withdrawal and the tuition fees involved. Key elements of the form include sections for student information, details about the program, and specific calculations to determine the refund due. Additionally, schools are required to keep supporting documentation on hand, ready for TWC review. Understanding the nuances of the Ps 1040R is essential for both educational institutions and students to ensure that all financial transactions are handled correctly and transparently.

Texas Ps 1040R Preview

TEXAS WORKFORCE COMMISSION

Career Schools and Colleges

Refund Worksheet - Vocational Programs

Instructions: Use this worksheet with all refunds for programs approved by TWC to demonstrate that each refund meets the state’s minimum cancellation and refund requirement, even if your school’s policy exceeds minimum requirements. Include the completed worksheet in the student’s file. You must have all supportive documentation listed on page 2 readily available upon TWC request; we encourage you to attach copies of that documentation to this worksheet in the student’s file. Use a separate worksheet for each program.

Date of this Refund Calculation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

School #S

 

School Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Student’s Name

 

 

 

 

 

 

 

Student’s SSN #

 

 

 

 

 

 

 

 

Student’s Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Student’s Phone #

 

 

 

 

 

 

Refund Computed By

 

 

 

 

 

 

 

 

 

Type of funding (Check all applicable) LOAN,

GRANT

CASH,

SPONSORED (by

)

 

 

Program Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Full name as it appears on the List of Approved Courses of Instruction)

 

 

 

 

 

 

 

 

Did the student drop from the program within 72 hours (until midnight of the third day,

 

 

Yes

 

No

 

 

 

 

 

excluding Saturdays, Sundays and legal holidays) after the enrollment contract was signed?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If the answer is Yes the student is due a full refund.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did the student drop within the first 3 scheduled class days?

 

 

 

 

 

 

Yes

 

No

 

Note: If the student dropped during the first 3 scheduled class days, the school may retain not more than $100 in administrative fees and items of extra expense that are necessary for the portion of the program attended. Anything retained must be stated separately on the enrollment agreement.

Total Course Time in the whole program (1a)

Tuition and included fees for the whole program

(1b)

$

Total Course Time in the portion charged (2a)

 

 

Tuition and included fees for the portion charged

(2b)

$

(1)Program hours and costs should reflect totals adjusted for credit given for previous education and training, if applicable.

(2)Course Time and Tuition for the current portion charged. The current portion charged may be the whole program.

Administrative fee for the whole program (May not exceed $100): $

Other charges for the whole program $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of enrollment in the program

 

 

Date of termination from the program

 

 

 

 

 

 

For the Current Portion Charged:

(Use these four items to check against the calculation for #4 below).

 

First Day of Attendance (Date)

 

 

 

 

Last Day of Attendance (Date)

 

 

 

Hours Scheduled Per Day

 

 

 

 

Days Scheduled Per Week

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

What portion of the program is the current portion for which the student has been charged?

 

 

The whole program

Calculate items below for the entire program.

 

 

A part of the program Into how many portions is the program divided?

 

 

 

 

For which portion is the student charged? Portion #:

 

 

 

Calculate items below for this portion.

 

For the current portion of the program for which the student is charged:

 

 

 

 

 

 

 

 

 

 

 

 

 

Use whole hours, rounding to the nearest hour if necessary.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

How many hours did the student attend?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

For how many hours was the student absent?

+

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Calculate the total hours the student was scheduled for:

=

 

 

 

 

 

 

 

 

(through the last date of

 

 

attendance)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

What is the Total Course Time in this portion of program?

 

 

 

 

 

 

(must match Total Course Time (2a)

 

 

above)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Calculate the percentage of the program’s Total Course

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Time for which the student was scheduled:

.

( #4 ÷ #5 ) Will be a decimal.

Calculate to three decimal places (example: .452 (45.2%).

Use #6 to calculate #7. If greater than .75 (75% of this portion of the program), use 1.0 (100%) in the calculation.

Page 1 of 2

PS-1040R

PREVIOUS EDITIONS OF THIS FORM WILL NOT BE USED

REV 11/13

7.Calculate tuition and included fees earned by the school for the current portion charged:

Tuition and included fees for current portion charged

$

 

(2b from previous page)

 

 

 

 

 

 

 

#6 (From previous page)

× .

 

=

$

 

 

 

 

 

 

 

 

 

 

8. Total of tuition and fees earned from prior (How many?

 

) portions charged

 

$

 

 

 

 

 

 

 

 

 

 

Earned fees and supplies for the whole program:

9.

Administrative fees earned, but not included in tuition (not to exceed $100.00)

$

 

 

10.

Chargeable* books not included in tuition (receipts required):

$

 

 

11.

Chargeable* supplies and other fees not included in tuition (receipts required):

+ $

 

 

 

*Must be necessary for portion of program attended & separately stated in enrollment agreement

 

 

 

 

12.

Total earned by school for the whole program

(items 7 + 8 + 9 + 10 + 11) = $

 

 

 

 

 

 

 

13.

Total amount paid towards #12 on behalf of student (Fees, Tuition, Books, Supplies) $

 

 

 

 

 

 

 

14.

Refund due (if #13 is greater than Item #12) =

 

$

 

 

15.

Balance due school (if #13 is less than Item #12)

 

$

 

 

Documentation:

The following documents must be readily available, preferably attached to this Refund Worksheet in the Student’s file:

1.Enrollment Agreement

2.Record of Previous Education & Training (PS-010)

3.Complete attendance record

4.Complete progress record w/status changes

5.LOA/make-up requests (if applicable)

6.Ledger

7.Book & supply receipts (if applicable)

8.Proof of consummation of refund

For questions concerning Texas Workforce Commission Career Schools and Colleges Cancellation and Refund Policy, please consult the form series PS-023; law governing Career Schools and Colleges, Title 3, Texas Education Code, Section 132.061 and 132.0611; and the Texas Career Schools and Colleges Rules, Title 40, Texas Administrative Code, Sections 807.261 through 807.264.

___________________________________________________________________________________________________________________________

Completed forms, inquiries, or corrections to the individual information contained in this form shall be sent to the TWC Career Schools and Colleges, 101 East 15th Street, Room 226T, Austin, Texas 78778-0001, (512) 936-3100. Individuals may receive and review information that TWC collects about the individual by emailing to open.records@twc.state.tx.us or writing to TWC Open Records, 101 E. 15th St., Rm. 266, Austin, TX 78778-0001.

___________________________________________________________________________________________________________________________

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PS-1040R

PREVIOUS EDITIONS OF THIS FORM WILL NOT BE USED

REV 11/13

Document Specs

Fact Name Description
Governing Law The Texas Ps 1040R form is governed by Title 3, Texas Education Code, Sections 132.061 and 132.0611.
Purpose This form is a Refund Worksheet for vocational programs approved by the Texas Workforce Commission (TWC).
Documentation Requirement Schools must maintain all supportive documentation readily available for TWC upon request.
Full Refund Eligibility If a student drops within 72 hours of signing the enrollment contract, they are entitled to a full refund.
Administrative Fees Schools may retain up to $100 in administrative fees if a student drops within the first 3 scheduled class days.
Calculation of Refund The refund amount is calculated based on the total course time and the portion of the program attended by the student.
Earned Fees Schools must calculate and report tuition and fees earned for the portion of the program attended by the student.
Submission Details Completed forms and inquiries should be sent to the TWC Career Schools and Colleges in Austin, Texas.
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