The University of the State of New York
THE STATE EDUCATION DEPARTMENT
Office of Vocational and Educational Services for Individuals with Disabilities (VESID)
Strategic Evaluation Data Collection, Analysis and Reporting (SEDCAR)
One Commerce Plaza - Room 1613
Albany, NY 12234-0001

SEDCAR - 1
APPROVED SPECIAL EDUCATION PROGRAM REQUEST FOR IDEA SUB-ALLOCATION
2005-2006

The following types of schools must use this form to request a sub-allocation of IDEA funds from school districts that have Committee on Preschool Special Education (CPSE) or Committee on Special Education (CSE) responsibility for students with disabilities:

Instructions:

  1. A completed SEDCAR-1 form, with original signature, is due by March 3, 2005 to each local education agency from which an IDEA sub-allocation for 2005-2006 year is requested.

  1. There is no need to submit a copy of this form to the State Education Department.

  1. A listing of the names of students comprising the counts reported in Section 3, Tables A and B, must be submitted to the LEA with this form, and marked "confidential".

  1. Retain one copy (and supporting documentation) in your school for reference and audit purposes. The required retention period ends June 30, 2011.

  1. If you have any questions about this report, please call (518) 474-7965, or (518) 486-4734.

 

Section 1: Approved Special Education Program Requesting Sub-Allocation

(Enter 12-digit SED Code Below)

                       
SCHOOL NAME

 

ADDRESS (include building name, room number, or mail stop information)


 

CITY STATE ZIP

Contact Person of Approved Special Education Program Requesting Sub-Allocation

NAME/TITLE
TELEPHONE (Include Area Code) FAX

 

IMPORTANT NOTE: The LEA must receive this form by March 3, 2005; in order to provide a sub-allocation of IDEA funds to approved special education programs for the 2005-2006 school year.

 

Section 2: Local Education Agency (LEA) Requested to Issue Sub-Allocation

(Enter 12-digit SED Code Below)

                       
LOCAL EDUCATION AGENCY NAME

 

ADDRESS (include building name, room number, or mail stop information)


 

CITY STATE ZIP

 

Section 3: Child Counts, Pursuant to IDEA Section 611 and 619, For Students Residing in LEA Listed in Section 2. (For students placed in out-of-State schools by the courts or State agencies, the LEA is the school district in which the student resided at the time of such placement.)

A Students with disabilities, ages 3-5, on December 1, 2004 (please determine enrollment and age as of December 1, 2004.

Count
611

Count
619

1 Count of preschool students (All students who receive preschool special education services pursuant to Section 4410 from this approved provider may be counted, including those preschool students who receive only related services. Please note if students receive services from more than one provider, only the provider that is designated as the "coordinating provider" may report the student on this form.)    
2 Count of students attending school-age programs    
(Note: Each student eligible to be counted under Section 619 is also eligible to be counted under Section 611*.)

 

B Students with disabilities, ages 6-21, on December 1, 2004 (please determine enrollment and age as of December 1, 2004.

Count
611

Count
619

1 Count of students with disabilities, ages 6-21 NA

*IDEA Section 619 flow-through funds are directed to students with disabilities, ages 3-5. Section 611 flow-through funds are directed to students with disabilities, ages 3-21.

Certification and Assurances

I have reviewed the information reported in this form and certify that this is a complete and accurate count of students with disabilities who were placed in this program by the local education agency listed in Section 2 of this form, on December 1, 2004. I certify that such students placed in this school were served in a manner consistent with their respective Individualized Education Programs. A listing of the names of the students reported in Section 3, Tables A and B, will be submitted to the local education agency with this form and marked "confidential".

 

__________________________
Original Ink Signature

___________________
Date Signed

left arrow Chief Administrative Officer
Must Sign and Date


__________________________________
Name of Chief Administrative Officer
(Please Type or Print)

     

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