New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 042901
PORTVILLE Municipal Code: 040768300100
500 ELM ST Date of Payment: Sept 2, 2008
PORTVILLE, NY 14770-9791 Amount of Payment: $0.00
2007-08 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc) $494,156.00
2. Total Aug State Share Medicaid Amount
3. Total Sept State Share Medicaid Amount $5,392.50
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) $118,146.50
7. December Net Excess Cost Payment $118,146.50
8. TOTAL EXCESS COST AID (less Estimated or calc) $501,863.00
9. Total Dec State Share Medicaid Amount
10. Total Jan State Share Medicaid Amount $1,418.50
11. Total Feb State Share Medicaid Amount
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $226,346.60
13. March Net Excess Cost Payment $226,346.60
14. TOTAL EXCESS COST AID (less Estimated or calc) $509,545.00
15. Total Mar State Share Medicaid Amount $7,697.60
16. Total Apr State Share Medicaid Amount
17. Total May State Share Medicaid Amount $11,613.18
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $62,498.37
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $62,498.37
23. TOTAL EXCESS COST AID (less Estimated or calc) $509,545.00
24. Total June State Share Medicaid Amount
25. Total July State Share Medicaid Amount
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $76,431.75
27. August Net Excess Cost Payment $76,431.75
28. TOTAL EXCESS COST AID $509,545.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC)
30. September Net Excess Cost Payment
Deposit will take place sometime during the payment day and funds will be
available the following day.
(ST-3 Code A3101 Basic Formula Aid - Excess Cost Only)
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