New York State Education Department
Office of Management Services
State Aid Unit
(518) 474-2977
TREASURER District Code: 570302
BATH CSD Municipal Code: 460605600200
25 ELLAS AVE Date of Payment: Sept 2, 2008
BATH, NY 14810-1107 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) $1,573,226.00
2. Total Aug State Share Medicaid Amount
3. Total Sept State Share Medicaid Amount
4. Total Oct State Share Medicaid Amount $9,767.00
5. Total Nov State Share Medicaid Amount $3,019.00
6. December Gross Payment (Line 1 X .25 - tot St Sh Medicaid) $380,520.50
7. December Net Excess Cost Payment $380,520.50
8. TOTAL EXCESS COST AID (less Estimated or calc) $1,577,293.00
9. Total Dec State Share Medicaid Amount $2,855.50
10. Total Jan State Share Medicaid Amount
11. Total Feb State Share Medicaid Amount $21,468.50
12. March Gross Payment (Line 8 x .70 - tot St Sh Medicaid & EC) $686,474.60
13. March Net Excess Cost Payment $686,474.60
14. TOTAL EXCESS COST AID (less Estimated or calc) $1,577,293.00
15. Total Mar State Share Medicaid Amount
16. Total Apr State Share Medicaid Amount $28,448.70
17. Total May State Share Medicaid Amount $10,323.00
18. June Gross Payment (Line 14 x .85 - tot St Sh Medicaid & EC) $197,822.25
19. Less Adjustments for Therapeutic Foster Care
20. June Net Excess Cost Payment $197,822.25
23. TOTAL EXCESS COST AID (less Estimated or calc) $1,577,293.00
24. Total June State Share Medicaid Amount $2,592.00
25. Total July State Share Medicaid Amount $216.00
26. August Gross Payment (Line 23 - tot St Sh Medicaid & EC) $233,785.95
27. August Net Excess Cost Payment $233,785.95
28. TOTAL EXCESS COST AID $1,577,293.00
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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