New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 141601
HAMBURG CSD Municipal Code: 140636100100
5305 ABBOTT RD Date of Payment: DEC 15, 2008
HAMBURG, NY 14075-1699 Amount of Payment: $882,333.25
2008-09 Certificate of Excess Cost Aid for Students with Disabilities
1. TOTAL EXCESS COST AID (less Estimated or calc) $3,529,333.00
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) $882,333.25
7. December Net Excess Cost Payment $882,333.25
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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