Adoption Assistance - Reimbursement Form

This is the reimbursement application for the Adoption Assistance Program. Under this program, the University reimburses up to $5,000 ($6,000 for a child with special needs) in adoption expenses for all full-time Faculty (Code 102), Administrative/Professional Staff (Code 100), and Professional Research Staff (Code 103). If an employee and his/her spouse or domestic partner both work at NYU, the two together are eligible to be reimbursed up to a maximum of $5,000 per adoption. In the case of the simultaneous adoption of two eligible children, the maximum reimbursement will be $10,000 for all combined "qualified adoption expenses."

To be eligible the full-time faculty or professional staff member must have:

• Adopted a child who is under the age of 18 and is not the child of the employee's spouse or domestic partner.
• "Qualified expenses" related to the adoption of a child incurred on or after the employee's first day of NYU employment.
• Completed and submitted the reimbursement form no sooner than the date that the eligible child was placed in the employee's home, and no later than six (6) months from the date the adoption was finalized.

For more details about the Adoption Assistance Program, including a statement of "qualified adoption expenses," see the Adoption Assistance program brochure or contact Family and Community Initiatives by phone at 212-998-9085 or online at www.nyu.edu/family.care.

Instructions:

1. Read the program brochure.
2. Download or request a reimbursement form from the Family and Community Initiatives by phone at 212-998-9085 or online at www.nyu.edu/family.care.
3. Complete and submit the reimbursement form no sooner than the date that the eligible child was placed in the employee's home, and no later than six (6) months from the date the adoption was finalized.
4. Send the completed form, with verifying documents and invoices substantiating that expenses constitute "qualified adoption expenses" to: Family and Community Initiatives, Office of Faculty Resources, 194 Mercer Street, Room 404B, New York, NY 10012