Rich Eccles - Business Manager: reccles@gfautah.org
Sharon Newbold - Asst. Business Manager: snewbold@gfautah.org

Cache School District
876000482
84 E 2400 N
North Logan, UT 84341
www.ccsdut.org

Logan School District
876000500
101 W Center St
Logan, UT 84321
www.loganschools.org/

Morgan School District
876000502
67 N 200 E
Morgan, UT 84050
www.morgansd.org/

Davis School District
876000487
45 E State St
PO Box 588
Farmington, UT 84025
www.davis.k12.ut.us

Greenwood Charter School
471439324
840 US-89
Harrisville, UT 84404 https://www.greenwoodcharter.org

Murray School District
876000503
5102 Commerce Drive
Murray, Utah 84107
LeAuna Brown @ 801-264-7487
lbrown@murrayschools.org
https://www.murrayschools.org

Ogden Preparatory Academy (OPA)
352210009
1435 Lincoln Ave
Ogden, UT 84404
https://ogdenprep.org/

Alpine School District
876000478
575 N 100 E
American Fork, UT 84003
alpineschools.org/

Grand School District
841002372
264 S 400 E
Moab, UT 84532
https://www.grandschools.org/

Sevier School District
EIN:
180 E 600 N
Richfield, UT 84701
https://www.seviersd.org

Duchesne School District
870685367
1010 E 200 N
Roosevelt, UT 84066
https://www.dcsd.org

Preston School #201
826000749
105 E 2nd S
Preston, ID 83263
www.psd201.org

Leadership Learning Academy
453821104
1111 2nd St
Ogden, UT 84404
www.llacharter.org

Maria Montessori Academy

263938335

Academica West handles PSLF forms

2505 N 200 E

North Ogden, UT 84414

https://www.mariamontessoriacademy.org/

Jordan School District
876000497

7387 S Campus View Dr

West Jordan, UT 84084

https://jordandistrict.org/

*TLF form must be signed prior to sending

Uintah School District

876000524

826 S 1500 E

Naples, UT 84078

www.uintah.net

Washington County School District

876000531

121 W Tabernacle

St. George UT 84770

www.washk12.org

Clark County School District

886000030

2832 E Flamingo Rd

Las Vegas, NV 89121

Google Doc Form for TLF Upload

State of Utah
876000545

Intermountain Health

870269232

Utah State University

876000528

Internal Revenue Service (IRS)

720564834

Other Fed Govt EINs

HCO.HRSS.Florence@irs.gov

Fax: 855-890-0420

TLF Email:

School District,

Please complete Section 5 of the attached PDF and return directly to the educator. Template here

Crucial: Must use MM/DD/YYYY format

Educator,

When you receive the form back from the school district please do the following:

Page 1: Write in your social
Page 2: Write in your social (top-right section)
Page 3: Write in your social and sign & date MM/DD/YYY
Page 4: Write in your social
Send the completed form to your loan servicer. Only pages 1-4 are necessary

PSLF Email:

School District,

On page 3 of the attached please enter the employment begin date and sign & date. Return directly to the educator. Thanks!

Educator,

When you receive the form back from the school district please do the following:

Page 1: Write in your social
Page 2: Write in your social, sign, and date
Page 3: Write in your social
Send the completed form (3 pages only) to the U.S. Department of Education as per Section 8 of the form. That info is listed below as a quick reference:

Fax: 540-212-2415

- or -

Mail to:

U.S. Department of Education

P.O. Box 300010

Greenville, TX 75403

Common Contacts

Box Elder School District:

Kimberly Bott

kimberly.bott@besd.net

Ogden School District:

Margarita Lezama Garcia

lezama.margarita@ogdensd.org

Weber School District:
hrfax@wsd.net

Davis School District:

payrolloffice@dsdmail.net

Coerina Fife - Executive Director - Personnel / Title IX
435-734-4800
coerina.fife@besd.net

Jessica Bennington - Executive Director of Human Resources
801-737-7343
benningtonj@ogdensd.org

Nicole Meibos - Human Resources Director
nmeibos@wsd.net
801-476-7800

Kalaya Jasperson
Job Title: HR Administrative Assistant
Email: kajasperson@wsd.net
Phone: 801-476-7805

Send TLF forms to Kalaya and Nicole Meibos

Preston School #201 826000749 105 E 2nd S Preston, ID 83263 www.psd201.org Leadership Learning Academy 453821104 1111 2nd St Ogden, UT 84404 www.llacharter.org

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