New York State Education Department                       
                         Office of Management Services                          
                                 State Aid Unit                                 
                                 (518) 474-2977                                 
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
      TREASURER                          District Code:    040901               
      ELLICOTTVILLE CSD                  Municipal Code:   040726500100         
      5873 RT 219                        Date of Payment:  DEC 15, 2008         
      ELLICOTTVILLE, NY  14731-9719      Amount of Payment:        $41,312.25   
                                                                                
                                                                                
     2008-09 Certificate of Excess Cost Aid for Students with Disabilities      
                                                                                
 1. TOTAL EXCESS COST AID (less Estimated or calc)           $165,249.00        
 2. Total Aug State Share Medicaid Amount                                       
 3. Total Sept State Share Medicaid Amount                                      
 4. Total Oct State Share Medicaid Amount                                       
 5. Total Nov State Share Medicaid Amount                                       
 6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid)       $41,312.25 
 7. December Net Excess Cost Payment                                 $41,312.25 
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                
 Check will be mailed under separate cover from the Division of the Treasury.   
 (ST-3 Code A3101 Basic Formula Aid - Excess Cost Only)                         
                                                                                
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