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PA 75 and Reimbursement for 3 Healthcare Contributions

If you were employed by Hillsdale Community Schools and reported earnings to the Office of Retirement Services between July 2010 and September 2012, you may be eligible for a reimbursement of the 3% helthcare contributions during that period. The state of Michigan will return those funds to the district, who in turn will reimburse the individual directly.  To ensure the district has your current contact information and up to date W4 information please complete the three (3) forms and send those to the business office.  Changes cannot be made over the phone.  Change forms must be received in writing.

Change Form for Personal Contact Information

Federal W-4 Form

Michigan W-4 Form

These completed forms can be sent to the Administrative Assistant for Human Resources by any of the ways listed below. 

Email Address: 

Mailing Address: 30 S. Norwood Ave, Hillsdale, MI 49242

Fax Number: 517-439-4194