1319 Earl Campbell Parkway, Tyler, Texas 75701 | tylerisd.org

Rev 12-18

New Hire Packet for ALL New Employees

All new employees are required to attend New Employee Orientation prior to their hire date. Please complete

this new hire packet and bring to your scheduled New Employee Orientation.

NOTE: DO NOT PRINT DOUBLE-SIDED.

**************************************************************

_______________________________________ __________________________ Employee Name Date

Please bring the following documents to the New Employee Orientation:

Social Security Card (for Payroll purposes) - A copy of the original must be made by HR

I.D. for Form I-9, Employment Eligibility Verification - See included list of acceptable documents

Official transcripts of all college course work

- Faxes or copies are not acceptable

- Electronic transcripts accepted only if sent directly by the issuing accredited educational institution to

your Tyler ISD Records Officer

- Official transcripts must be received by HR in a sealed envelope from the issuing educational institution

- Official Transcript verifying Master’s or Doctorate Degree is required in order to receive $1,000 Master’s

stipend or $500 Doctorate Stipend

Original service records - Previous employment experience in an accredited public or private educational

institution required for salary credit; copies, fax or e-mail are not accepted

- For Texas experience, request your original service records from your previous district

- For experience outside of Texas in a public or private school, or a College or University, a TEA Service

Record form and a Verification of Accreditation Status form are required. These forms are available on

the Tyler ISD website under “Employees” / “Newly Hired Employees”. Both forms must be completed

by the previous out of state district(s) and originals returned to your Tyler ISD Records Officer.

* If you are awaiting original service records or official transcripts, you may still

attend your scheduled orientation.

For questions regarding required documents, contact your Tyler ISD Records Officer

Professional/ParaprofessionalLast Name A – I

Last Name J – Q Last Name R – Z

Cindy Bright

Jessica Gurrusquieta Martha Miller

903-262-1072903-262-1012

Auxiliary David Rodriguez

Cindy.Bright@tylerisd.org

Jessica.Gurrusquieta@tylerisd.org Martha.Miller@tylerisd.org

David.Rodriguez@tylerisd.org 903-262-1073

903-262-1074

USCIS Form I-9

OMB No. 1615-0047 Expires 10/31/2022

Employment Eligibility Verification Department of Homeland Security

U.S. Citizenship and Immigration Services

Form I-9 10/21/2019 Page 1 of 3

►START HERE: Read instructions carefully before completing this form. The instructions must be available, either in paper or electronically, during completion of this form. Employers are liable for errors in the completion of this form. ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOT specify which document(s) an employee may present to establish employment authorization and identity. The refusal to hire or continue to employ an individual because the documentation presented has a future expiration date may also constitute illegal discrimination.

Section 1. Employee Information and Attestation (Employees must complete and sign Section 1 of Form I-9 no later than the first day of employment, but not before accepting a job offer.)Last Name (Family Name) First Name (Given Name) Middle Initial Other Last Names Used (if any)

Address (Street Number and Name) Apt. Number City or Town State ZIP Code

Date of Birth (mm/dd/yyyy)

- -

Employee's E-mail Address Employee's Telephone Number U.S. Social Security Number

1. A citizen of the United States

2. A noncitizen national of the United States (See instructions)

3. A lawful permanent resident

4. An alien authorized to work until (See instructions)

(expiration date, if applicable, mm/dd/yyyy):

(Alien Registration Number/USCIS Number):

Some aliens may write "N/A" in the expiration date field.

I am aware that federal law provides for imprisonment and/or fines for false statements or use of false documents in connection with the completion of this form.

I attest, under penalty of perjury, that I am (check one of the following boxes):

Aliens authorized to work must provide only one of the following document numbers to complete Form I-9: An Alien Registration Number/USCIS Number OR Form I-94 Admission Number OR Foreign Passport Number.

1. Alien Registration Number/USCIS Number:

2. Form I-94 Admission Number:

3. Foreign Passport Number:

Country of Issuance:

OR

OR

QR Code - Section 1 Do Not Write In This Space

Signature of Employee Today's Date (mm/dd/yyyy)

Preparer and/or Translator Certification (check one): I did not use a preparer or translator. A preparer(s) and/or translator(s) assisted the employee in completing Section 1.(Fields below must be completed and signed when preparers and/or translators assist an employee in completing Section 1.)I attest, under penalty of perjury, that I have assisted in the completion of Section 1 of this form and that to the best of my knowledge the information is true and correct.Signature of Preparer or Translator Today's Date (mm/dd/yyyy)

Last Name (Family Name) First Name (Given Name)

Address (Street Number and Name) City or Town State ZIP Code

Employer Completes Next Page

LISTS OF ACCEPTABLE DOCUMENTSAll documents must be UNEXPIRED

Employees may present one selection from List A or a combination of one selection from List B and one selection from List C.

LIST A

2. Permanent Resident Card or AlienRegistration Receipt Card (Form I-551)

1. U.S. Passport or U.S. Passport Card

3. Foreign passport that contains atemporary I-551 stamp or temporaryI-551 printed notation on a machine-readable immigrant visa

4. Employment Authorization Documentthat contains a photograph (FormI-766)

5. For a nonimmigrant alien authorizedto work for a specific employerbecause of his or her status:

Documents that Establish Both Identity and

Employment Authorization

6. Passport from the Federated Statesof Micronesia (FSM) or the Republicof the Marshall Islands (RMI) withForm I-94 or Form I-94A indicatingnonimmigrant admission under theCompact of Free Association Betweenthe United States and the FSM or RMI

b. Form I-94 or Form I-94A that hasthe following:(1) The same name as the passport;

and(2) An endorsement of the alien's

nonimmigrant status as long asthat period of endorsement hasnot yet expired and theproposed employment is not inconflict with any restrictions orlimitations identified on the form.

a. Foreign passport; and

For persons under age 18 who are unable to present a document

listed above:

1. Driver's license or ID card issued by aState or outlying possession of theUnited States provided it contains aphotograph or information such asname, date of birth, gender, height, eyecolor, and address

9. Driver's license issued by a Canadiangovernment authority

3. School ID card with a photograph

6. Military dependent's ID card

7. U.S. Coast Guard Merchant MarinerCard

8. Native American tribal document

10. School record or report card

11. Clinic, doctor, or hospital record

12. Day-care or nursery school record

2. ID card issued by federal, state or localgovernment agencies or entities,provided it contains a photograph orinformation such as name, date of birth,gender, height, eye color, and address

4. Voter's registration card

5. U.S. Military card or draft record

Documents that Establish Identity

LIST B

OR AND

LIST C

7. Employment authorizationdocument issued by theDepartment of Homeland Security

1. A Social Security Account Numbercard, unless the card includes one ofthe following restrictions:

2. Certification of report of birth issuedby the Department of State (FormsDS-1350, FS-545, FS-240)

3. Original or certified copy of birthcertificate issued by a State,county, municipal authority, orterritory of the United Statesbearing an official seal

4. Native American tribal document

6. Identification Card for Use ofResident Citizen in the UnitedStates (Form I-179)

Documents that Establish Employment Authorization

5. U.S. Citizen ID Card (Form I-197)

(2) VALID FOR WORK ONLY WITHINS AUTHORIZATION

(3) VALID FOR WORK ONLY WITHDHS AUTHORIZATION

(1) NOT VALID FOR EMPLOYMENT

Page 4 of 4Form I-9 10/21/2019

Examples of many of these documents appear in the Handbook for Employers (M-274).

Refer to the instructions for more information about acceptable receipts.

2018-2019 Texas Education Data Standards Appendix 8.F – PEIMS Supplemental Information for Reporting Ethnicity and Race Data Reporting Final Version

2019.1.0

Texas Education Agency Texas Public School Student/Staff Ethnicity and Race Data Questionnaire

The United States Department of Education (USDE) requires all state and local education institutions to collect data on ethnicity and race for students and staff. This information is used for state and federal accountability reporting as well as for reporting to the Office of Civil Rights (OCR) and the Equal Employment Opportunity Commission (EEOC).

School district staff and parents or guardians of students enrolling in school are requested to provide this information. If you decline to provide this information, please be aware that the USDE requires school districts to use observer identification as a last resort for collecting the data for federal reporting.

Please answer both parts of the following questions on the student’s or staff member’s ethnicity and race. United States Federal Register (71 FR 44866)

Part 1. Ethnicity: Is the person Hispanic/Latino? (Choose only one)

Hispanic/Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Not Hispanic/Latino

Part 2. Race: What is the person’s race? (Choose one or more)

American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains a tribal affiliation or community attachment.

Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Black or African American - A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Student/Staff Name (please print) (Parent/Guardian)/(Staff) Signature

Student/Staff Identification Number Date

This space reserved for Local school observer – upon completion and entering data in student software system, file this form in student’s permanent folder. Ethnicity – choose only one:

Hispanic / Latino

Not Hispanic/Latino

Race – choose one or more: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

Observer signature: Campus and Date:

Texas Education Agency – March 2018

New Employee Public Access Option Form February 2019

PUBLIC ACCESS OPTION FORM

Texas Government Code Section 552.024

_____________________________________ ____________________________________

Employee name (print) Campus/Department

In accordance with Texas Government Code §552.022, the name, sex, ethnicity, salary, title, and dates of

employment of each employee of the Tyler Independent School District is public information. However, Texas

Government Code §552.024 allows employees to elect whether to keep certain information confidential if

requested under the Texas Public Information Act. Social Security numbers and family member information are

protected by Tyler ISD to ensure this information remains private.

Unless you choose to keep it confidential, the following information about you may be subject to public release

if requested under the Texas Public Information Act. Please indicate whether you wish to allow public release

of your information by checking Yes or No below.

Public Access

No Yes

Home Address

Home Phone

Cell Phone

Note: Social Security numbers and Family Member information are automatically protected by Tyler ISD.

Employees may update their selections at any time using the Tyler ISD Employee Service Center.

___________________________________ ________________________

Signature Date

Revised 10-11-2019

Tyler ISD Employee Information and Acknowledgements

______________________________________ Printed Name of Employee Telephone # (Home) (Cell)

Insurance Information I understand that I am responsible for electing or declining Insurance Benefits online through The Benefits HUB. I am responsible for completing this process within 30 days of my hire date. Complete online enrollment in the Employee Service Center under "My Benefits Information".

I further understand that if I do not elect or decline medical coverage within 30 days of my hire date, I will be automatically enrolled in the HD Plan and $102.00 will be deducted monthly from my paycheck. I will not be eligible to make any enrollment changes until the next open enrollment period.

Contact Benefits Support Specialist at 903.262.1082 with any insurance-related questions.

Employee Handbook I agree to complete my acceptance of the employee handbook electronically and to read and abide by the standards, policies, and procedures defined or referenced in the employee handbook. The information in the employee handbook is subject to change, and I understand that changes in district policies may supersede, modify, or eliminate the policies summarized in the employee handbook. I accept responsibility for reading and abiding by the changes. I understand that no modifications to contractual relationships or alterations of at-will relationships are intended by this handbook. I accept responsibility for contacting my supervisor or Human Resources if I have any questions or concerns requiring further explanation.

I understand that I have an obligation to update the online Employee Service Center with any changes in my personal information, such as phone numbers, address, etc.

Job Description I have reviewed the job description for which I am being hired. All job descriptions are accessible at the Tyler ISD website on the Human Resources Department page under Job Descriptions. I fully understand the job description and further understand that I am responsible for the satisfactory execution of the essential functions described therein.

Your signature below indicates your acknowledgement of the above statements:

Employee Signature _____________________________ Date ______________________

Home Address

_____________________________________________________________________________________________ Street Address City Zip Code

Mailing Address (if different from above)

_____________________________________________________________________________________________ Street Address City Zip Code

Complete if applicable:

Last district employed_______________________________________

Years of previous experience w/ a school district _________ Highest Degree _________________________________

* A copy of the form will be sent to the Tyler ISD department of Risk Management

1319 Earl Campbell Parkway, Tyler, Texas 75701 tylerisd.org

NOTICE TO EMPLOYEES CONCERNING WORKERS’ COMPENSATION COVERAGE

Reference Rule 110.101

Tyler ISD provides workers’ compensation insurance coverage from Claims Administrative Services in the event of any work-related injury or occupational disease. This coverage is effective beginning on the employee date of hire. Any injuries or occupational diseases which occur on or after that date will be handled by Claims Administrative Services. An employee, or a person acting on the employee’s behalf,must notify the employer of an injury or occupational disease not later than the 30th day after the date on which the injury occurs or the date the employee knew or should have known of an occupational disease, unless the Texas Department of Insurance, Workers’ Compensation Division determines that good cause existed for failure to provide timely notice. Your employer is required to provide you with information regarding coverage when you are hired or if your employer ceases to be covered.

Employee assistance is available from your local workers’ compensation division office, or by calling 1-800-252-7031.

You may elect to retain your common law right of action if, no later than five days after you begin employment or within five days after receiving written notice from the employer that the employer has obtained workers’ compensation insurance coverage, you notify your employer in writing that you wish to retain your common law right to recover damages for personal injury.

IF YOU ELECT TO RETAIN YOUR COMMON LAW RIGHT OF ACTION, YOU CANNOT OBTAIN WORKERS’ COMPENSATION INCOME OR MEDICAL BENEFITS IF YOU ARE INJURED.

Sign only ONE of the selections below:

_______________________________________ _________________________ Signature Date

My signature above indicates I have reviewed this notice regarding workers’ compensationcoverage.

_____________________________________ _________________________ Signature Date

My signature above indicates I elect to retain my common law right of action and am aware by doing so I cannot obtain workers’ compensation income or medical benefits if I am injured.

Form SSA-1945 (01-2013) Destroy Prior Editions

Social Security Administration

Statement Concerning Your Employment in a Job Not Covered by Social Security

Employee Name

Employer Name

Employee ID(SS#)

Employer ID#

Your earnings from this job are not covered under Social Security. When you retire, or if you become disabled, you may receive a pension based on earnings from this job. If you do, and you are also entitled to a benefit from Social Security based on either your own work or the work of your husband or wife, or former husband or wife, your pension may affect the amount of the Social Security benefit you receive. Your Medicare benefits, however, will not be affected. Under the Social Security law, there are two ways your Social Security benefit amount may be affected.

Windfall Elimination Provision Under the Windfall Elimination Provision, your Social Security retirement or disability benefit is figured using a modified formula when you are also entitled to a pension from a job where you did not pay Social Security tax. As a result, you will receive a lower Social Security benefit than if you were not entitled to a pension from this job. For example, if you are age 62 in 2013, the maximum monthly reduction in your Social Security benefit as a result of this provision is $395.50. This amount is updated annually. This provision reduces, but does not totally eliminate, your Social Security benefit. For additional information, please refer to Social Security Publication, “Windfall Elimination Provision.”

Government Pension Offset Provision Under the Government Pension Offset Provision, any Social Security spouse or widow(er) benefit to which you become entitled will be offset if you also receive a Federal, State or local government pension based on work where you did not pay Social Security tax. The offset reduces the amount of your Social Security spouse or widow(er) benefit by two-thirds of the amount of your pension.

For example, if you get a monthly pension of $600 based on earnings that are not covered under Social Security, two-thirds of that amount, $400, is used to offset your Social Security spouse or widow(er) benefit. If you are eligible for a $500 widow(er) benefit, you will receive $100 per month from Social Security ($500 - $400=$100). Even if your pension is high enough to totally offset your spouse or widow(er) Social Security benefit, you are still eligible for Medicare at age 65. For additional information, please refer to Social Security Publication, “Government Pension Offset.”

For More Information Social Security publications and additional information, including information about exceptions to each provision, are available at www.socialsecurity.gov. You may also call toll free 1-800-772-1213, or for the deaf or hard of hearing call the TTY number 1-800-325-0778, or contact your local Social Security office.

I certify that I have received Form SSA-1945 that contains information about the possible effects of the Windfall Elimination Provision and the Government Pension Offset Provision on my potential future Social Security Benefits.

Signature of Employee Date

TYLER ISD 75-6002675

Form SSA-1945 (01-2013)

Information about Social Security Form SSA-1945 Statement Concerning Your Employment in a Job Not Covered by Social Security

New legislation [Section 419(c) of Public Law 108-203, the Social Security Protection Act of 2004] requires State and local government employers to provide a statement to employees hired January 1, 2005 or later in a job not covered under Social Security. The statement explains how a pension from that job could affect future Social Security benefits to which they may become entitled.

Form SSA-1945, Statement Concerning Your Employment in a Job Not Covered by Social Security, is the document that employers should use to meet the requirements of the law. The SSA-1945 explains the potential effects of two provisions in the Social Security law for workers who also receive a pension based on their work in a job not covered by Social Security. The Windfall Elimination Provision can affect the amount of a worker’s Social Security retirement or disability benefit. The Government Pension Offset Provision can affect a Social Security benefit received as a spouse, surviving spouse, or an ex-spouse.

Employers must:

• Give the statement to the employee prior to the start of employment;

• Get the employee’s signature on the form; and

• Submit a copy of the signed form to the pension paying agency.

Social Security will not be setting any additional guidelines for the use of this form.

Copies of the SSA-1945 are available online at the Social Security website, www.socialsecurity.gov/online/ssa-1945.pdf. Paper copies can be requested by email at ofsm.oswm.rqct.orders@ssa.gov or by fax at 410-965-2037. The request must include the name, complete address and telephone number of the employer. Forms will not be sent to a post office box. Also, if appropriate, include the name of the person to whom the forms are to be delivered. The forms are available in packages of 25. Please refer to Inventory Control Number (ICN) 276950 when ordering.

1319 Earl Campbell Parkway • P.O. Box 2035 • Tyler, Texas 75701 • 903.262.1000 • www.tylerisd.org District Alignment Pact

District Alignment Pact The Tyler Independent School District seeks to hire the very best employees, who are focused on producing the nation’s best students. By signing this pact, you acknowledge that you understand the Tyler ISD belief system and are ready and willing to rise to the many challenges that lay ahead in this great pursuit.

Vision

Tyler ISD Vision Statement: Tyler ISD will focus on successful student outcomes The Six Objectives Are:

1. All students will graduate prepared for college or career, and life-ready to compete in a global economy.

2. All students will learn in schools that meet the needs of our diverse community. 3. All students will learn from highly effective educators. 4. All students will learn in a safe, secure and positive learning environment. 5. All students will learn through comprehensive and innovative education. 6. All students will learn using a cutting-edge technology device in the educational classroom.

I, ___________________________, accept the position of ___________________________ in the Tyler Independent School District. As an employee of Tyler ISD, I promise to support the mission of the District. I acknowledge that I will not always agree with the decisions made by the District; however, once a decision is made, I will always maintain a positive attitude in order to support high morale, build a healthy culture, and keep the focus on student success and academic excellence for ALL children.

My signature indicates that I agree with this pact and understand that if I cannot uphold these beliefs, that I am willing to resign the above position with the District’s approval.

___________________________________________ Employee Signature ___________________________________________ Employee Name – Printed ___________________________________________ Date

__________________________________________ Tyler ISD Representative Signature __________________________________________ Tyler ISD Representative Name – Printed __________________________________________ Date

1319 Earl Campbell Parkway, Tyler, Texas 75701 tylerisd.org

Letter of Reasonable Assurance (Applies to non-contract, non-exempt paraprofessional and auxiliary employees only)

Name _________________________________ Campus/Department________________________

Position _________________________________________________

Please accept this letter as our means of informing you of reasonable assurance of continued employment with our district after a school break.

By virtue of this notice, please understand that you will not be eligible for unemployment compensation benefits drawn on school district wages during scheduled school breaks including, but not limited to, holiday, spring and summer breaks. This assurance is contingent upon continued school operations and will not apply in the event of any disruption that is beyond the control of the district (i.e. lack of school funding, natural disasters, court orders, public insurrections, war, etc.).

Nothing contained herein constitutes an employment contract. Your continued employment with Tyler ISD is on an “at will” basis. “At-will” employers may terminate employees at any time for any reason orfor no reason, except for legally impermissible reasons. “At-will” employees are free to resign at any time for any reason or for no reason.

Your services on behalf of the children of the district are appreciated.

Sincerely,

_________________________ Coordinator of Human Resources

Please sign this form verifying that you have received and understand the above information.

______________________________________ ________________________ Employee Signature Date

Compensatory Time Agreement

Staff positions are individually reviewed to determine whether they are eligible for, or exempt from, the overtime provisions of the Fair Labor Standards Act (FLSA). This designation may change over time due to modifications to the law, an individual’s work schedule, a change in job assignment or other relevant factors. Information about the overtime status of a position is included on the position description or an employee may contact the Payroll Department at 903-262-1018 (Paraprofessionals & Auxiliary) or 903-262-1081 (Transportation) to verify his/her status. Acceptance of compensatory time off in lieu of cash payment for overtime is a condition of employment at Tyler ISD. Compensatory time is awarded at one and one half hour for each hour of overtime worked.

Additional information about employment rights, privileges and benefits, as well as rules and procedures regarding the employment relationship can be found in Board Policy DEAB and Employee Handbook which is available on the Tyler ISD website www.tylerisd.org under the Human Resources Department.

I understand that if my position is eligible for overtime and I work more than 40 hours in a work week, acceptance of compensatory time in lieu of cash payment is a condition of my employment with Tyler Independent School District. Further, I understand that whether compensation for overtime is made by cash payment or compensatory time is at the discretion of the District.

Printed Name

Signature Date

Please bring this completed new hire packet to your New Employee Orientation.

If you are unable to print the packet, you may pick one up from the reception desk at the

Tyler ISD Administration building located at 1319 Earl Campbell Pkwy.

The packet must be complete prior to attending orientation.

NOTE: DO NOT PRINT DOUBLE-SIDED.

Once your hiring process is complete in the system, you will receive a ‘New Hire Email’ with the following information:

- Employee ID- System User Name- System password instructions- Information regarding contract acceptance (if applicable)- Additional document acceptance instructions

The new hire email will be sent to your personal email address included on your application.

Access your Tyler ISD Outlook email account with the User Name and Password as given above for your network login.

Action items listed below must be completed electronically in the Employee Service Center (ESC) once you receive your system user name and password.

Employee Service Center Emergency Contact Direct Deposit W4 Responsible Use Commitment Employee Handbook Public Access Option

You may obtain your Employee ID Badge upon receiving this New Hire Email at the Tyler ISD Police Department located at 807 W. Glenwood Blvd., Tyler, TX 75701. The Police Department telephone number is (903) 262-1111.

Additional information and instructions can be found on the Human Resources department page of the district website www.tylerisd.org.

Welcome to the Tyler ISD Family!We look forward to meeting you at New Employee Orientation.

Tyler ISD Vision Statement: Tyler ISD will focus on successful student outcomes.