New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 090201
AUSABLE VALLEY CSD Municipal Code: 090704100100
1273 RT 9 N Date of Payment: Sept 2, 2008
CLINTONVILLE, NY 12924-4244 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) $1,884,298.00
2. Total Aug State Share Medicaid Amount $3,408.00
3. Total Sept State Share Medicaid Amount $8,880.00
4. Total Oct State Share Medicaid Amount $215.00
5. Total Nov State Share Medicaid Amount
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid) $458,571.50
7. December Net Excess Cost Payment $458,571.50
8. TOTAL EXCESS COST AID (less Estimated or calc) $1,884,298.00
9. Total Dec State Share Medicaid Amount $48,051.00
10. Total Jan State Share Medicaid Amount $305.00
11. Total Feb State Share Medicaid Amount $907.50
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $798,670.60
13. March Net Excess Cost Payment $798,670.60
14. TOTAL EXCESS COST AID (less Estimated or calc) $1,884,298.00
15. Total Mar State Share Medicaid Amount $2,548.00
16. Total Apr State Share Medicaid Amount $24,840.00
17. Total May State Share Medicaid Amount
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $255,256.70
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $255,256.70
23. TOTAL EXCESS COST AID (less Estimated or calc) $1,884,298.00
24. Total June State Share Medicaid Amount $55,486.50
25. Total July State Share Medicaid Amount
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $227,158.20
27. August Net Excess Cost Payment $227,158.20
28. TOTAL EXCESS COST AID $1,884,298.00
29. September Gross Payment (Line 28 - tot St Sh Medicaid & EC)
30. September Net Excess Cost Payment
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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