NDE Form 06-025 "Final Financial Report for Children With Disabilities Birth to Age Five" - Nebraska

What Is NDE Form 06-025?

This is a legal form that was released by the Nebraska Department of Education - a government authority operating within Nebraska. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2018;
  • The latest edition provided by the Nebraska Department of Education;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of NDE Form 06-025 by clicking the link below or browse more documents and templates provided by the Nebraska Department of Education.

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Download NDE Form 06-025 "Final Financial Report for Children With Disabilities Birth to Age Five" - Nebraska

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NDE (06-025)
Return to:
SPECIAL EDUCATION
Nebraska Department of Education
Revised 07/2018
AND SUPPORT SERVICES
Date Due: October 31
Financial Services
FINAL FINANCIAL REPORT
P.O. Box 94987
FOR CHILDREN WITH DISABILITIES BIRTH TO AGE FIVE
Lincoln, NE 68509-4987
School Year
RESET FORM
2017-2018
INSTRUCTIONS
County Name
County/District Number
County Number and Name
District Name
Phone Number
Address
Nebraska
City
State
Zip Code
CERTIFICATION BY SCHOOL DISTRICT OFFICER
I,
as
of the Board of Education of
School District, which is District No._______, of
County, hereby certify that this is an accurate report of the district operated
County Number and Name
Special Education expenditures that have been paid by this school district for services to e ligible verified students with disabilities. I f urther certify that
Special Education c osts f inanced by federal funds other tha n those generated through the Individuals w ith Disabilities Educ ation Act (IDE A) are not
included in this claim.
Authorized Signature
Date
Name of Contact Person
E-mail Address
Birth to Age 2
Ages 3 and 4
Totals
District Owned/Operated Programs
(USE WHOLE DOLLARS)
1.0
Supervisory Services
1.1
Professional Salaries (110)
FTE
$
$
1.2
Clerical Salaries (140)
FTE
1.3
Employee Benefits (200s)
1.4
In-service (319)
1.5
Printing/Publications (350)
1.6
Postage (341)
1.7
Staff Mileage (670)
1.8
Subtotal of Lines 1.1 through 1.7
1.8 $
$
$
0
0
0
2.0
Diagnostic Services
2.1
Professional Salaries (110)
FTE
$
$
2.2
Clerical Salaries (140)
FTE
2.3
Paraprofessional Salaries (140)
FTE
2.4
Employee Benefits (200s)
2.5
In-service (319)
2.6
Supplies (410)
2.7
Printing/Publications (350)
2.8
Postage (341)
2.9
Textbooks/Instructional Materials (420)
2.10 Equipment and Maintenance (310 & 530)
2.11 Staff Mileage (670)
2.12 Subtotal of Lines 2.1 through 2.11
2.12 $
$
$
0
0
0
3.0 Consultative Services
3.1
Professional Salaries (110)
FTE
$
$
3.2
Employee Benefits (210,220,230,240,250,260)
3.3
In-service (319)
3.4
Printing/Publications (350)
3.5
Postage (341)
3.6
Staff Mileage (670)
3.7
Subtotal of Lines 3.1 through 3.6
3.7 $
$
$
0
0
0
4.0 Instructional/Therapy/Counseling Services
4.1
Professional Salaries (110)
FTE
$
$
4.2
Educational Sign Language Interpreter (110)
(Title 92, Nebraska Administrative Code, Chapter 51, Section 010.07)
FTE
4.3
Substitute Salaries (120)
FTE
4.4
Paraprofessional Salaries (140)
FTE
4.5
Employee Benefits (200s)
4.6
In-service (319)
4.7
Supplies (410)
4.8
Instructional Materials (420)
4.9
Library Books/Materials (430)
4.10 Audio-Visual Materials (450)
4.11 Equipment and Maintenance (318 & 530)
4.12 Staff Mileage (670)
4.13 Subtotal of Lines 4.1 through 4.12
4.13
$
$
$
0
0
0
SPED-FFR
Return Original to NDE; Make Copy and Retain in School District
- 1 -
NEXT PAGE
NDE (06-025)
Return to:
SPECIAL EDUCATION
Nebraska Department of Education
Revised 07/2018
AND SUPPORT SERVICES
Date Due: October 31
Financial Services
FINAL FINANCIAL REPORT
P.O. Box 94987
FOR CHILDREN WITH DISABILITIES BIRTH TO AGE FIVE
Lincoln, NE 68509-4987
School Year
RESET FORM
2017-2018
INSTRUCTIONS
County Name
County/District Number
County Number and Name
District Name
Phone Number
Address
Nebraska
City
State
Zip Code
CERTIFICATION BY SCHOOL DISTRICT OFFICER
I,
as
of the Board of Education of
School District, which is District No._______, of
County, hereby certify that this is an accurate report of the district operated
County Number and Name
Special Education expenditures that have been paid by this school district for services to e ligible verified students with disabilities. I f urther certify that
Special Education c osts f inanced by federal funds other tha n those generated through the Individuals w ith Disabilities Educ ation Act (IDE A) are not
included in this claim.
Authorized Signature
Date
Name of Contact Person
E-mail Address
Birth to Age 2
Ages 3 and 4
Totals
District Owned/Operated Programs
(USE WHOLE DOLLARS)
1.0
Supervisory Services
1.1
Professional Salaries (110)
FTE
$
$
1.2
Clerical Salaries (140)
FTE
1.3
Employee Benefits (200s)
1.4
In-service (319)
1.5
Printing/Publications (350)
1.6
Postage (341)
1.7
Staff Mileage (670)
1.8
Subtotal of Lines 1.1 through 1.7
1.8 $
$
$
0
0
0
2.0
Diagnostic Services
2.1
Professional Salaries (110)
FTE
$
$
2.2
Clerical Salaries (140)
FTE
2.3
Paraprofessional Salaries (140)
FTE
2.4
Employee Benefits (200s)
2.5
In-service (319)
2.6
Supplies (410)
2.7
Printing/Publications (350)
2.8
Postage (341)
2.9
Textbooks/Instructional Materials (420)
2.10 Equipment and Maintenance (310 & 530)
2.11 Staff Mileage (670)
2.12 Subtotal of Lines 2.1 through 2.11
2.12 $
$
$
0
0
0
3.0 Consultative Services
3.1
Professional Salaries (110)
FTE
$
$
3.2
Employee Benefits (210,220,230,240,250,260)
3.3
In-service (319)
3.4
Printing/Publications (350)
3.5
Postage (341)
3.6
Staff Mileage (670)
3.7
Subtotal of Lines 3.1 through 3.6
3.7 $
$
$
0
0
0
4.0 Instructional/Therapy/Counseling Services
4.1
Professional Salaries (110)
FTE
$
$
4.2
Educational Sign Language Interpreter (110)
(Title 92, Nebraska Administrative Code, Chapter 51, Section 010.07)
FTE
4.3
Substitute Salaries (120)
FTE
4.4
Paraprofessional Salaries (140)
FTE
4.5
Employee Benefits (200s)
4.6
In-service (319)
4.7
Supplies (410)
4.8
Instructional Materials (420)
4.9
Library Books/Materials (430)
4.10 Audio-Visual Materials (450)
4.11 Equipment and Maintenance (318 & 530)
4.12 Staff Mileage (670)
4.13 Subtotal of Lines 4.1 through 4.12
4.13
$
$
$
0
0
0
SPED-FFR
Return Original to NDE; Make Copy and Retain in School District
- 1 -
NEXT PAGE
Return to:
NDE (06-025)
SPECIAL EDUCATION
Nebraska Department of Education
Revised 07/2017
Date Due: October 31
AND SUPPORT SERVICES
Financial Services
FINAL FINANCIAL REPORT
P.O. Box 94987
FOR CHILDREN WITH DISABILITIES BIRTH TO AGE FIVE
Lincoln, NE 68509-4987
PREVIOUS PAGE
2017-2018
School Year
County Name
County/District Number
District Name
County Number and Name
Birth to Age 2
Ages 3 and 4
Totals
(USE WHOLE DOLLARS)
5.0 Health Protection/Medically Related Expenditures District Operated Programs
5.1
Health Protection for Staff
5.2
Medically Related Expenses for Child
0
0
0
5.3
Subtotal of lines 5.1 through 5.2
5.3 $
$
$
6.0 District Contracted Programs (362-363)
(List and Identify Approved Providers of Page 3)
6.1
Supervision Services & Mileage
$
$
6.2
Diagnostic Services & Mileage
6.3
Consultant Services & Mileage
6.4
Instruction Therapy/Counseling Services & Mileage
6.5
Educational Sign Language Interpreter
6.6
Health Protection for Staff
6.7
Medically Related Expenditures for Child
6.8
In-service
6.9
Paraprofessional
6.10 Health Services
6.11 Total Birth to Age Five Contracted Services
0
0
0
(Lines 6.1 through 6.10)
6.11 $
$
$
7.0 Allowable Facility Costs
7.1
Operation of Plant (2610)
$
$
7.2
Maintenance of Plant (2610)
0
0
7.3
Line 7.1 Plus Line 7.2
7.4
Total Facility Square Footage
1.#R
1.#R
7.5
Cost Per Square Foot (Line 7.3 divided by Line 7.4)
7.6
Total Square Footage, Birth to Age Five
0
0
7.7
Line 7.5 Times 7.6
7.8
Leased Facility Cost
7.9
Not Assigned
0
0
0
7.10 Total Allowable Facility Cost (Lines 7.7, 7.8 and 7.9)
7.10 $
$
$
8.0 Summary
0
0
8.1
District Owned and Contracted Services
$
$
(Add Lines 1.8, 2.12, 3.7, 4.13, 5.3, 6.11 and 7.10)
8.2
Deductions:
8.2a
Tuition Received
8.2b
Receipts, Wards of State
0
0
0
8.2c
Total Deductions (Line 8.2a through 8.2b)
8.2c $
$
$
0
8.3
Total Special Education (Line 8.1 minus Line 8.2c)
8.3
0
0
$
$
$
9.0 Funding Summary
Provide source of funding reported on Line 8.3
9.1 IDEA “611” BASE: funds used for allowable special education
0
expenditures for Children Below Age Five. (First Priority)
$
$
$
9.1a N/A
$
N/A
$
N/A
9.2 IDEA “619” BASE and/or “619” ENROLLMENT/POVERTY funds
used for allowable special education expenditures for children ages 3
0
and 4.
$
$
9.3 IDEA “611” ENROLLMENT/POVERTY funds used for allowable
special education expenditures for Children Below Age Five included
0
in Section 1.0-7.0.
$
$
$
9.4 N/A
$
N/A
$
N/A
$
N/A
9.5 Local District Funds: District funds for Below Age Five Expenditures
0
included in Section 1.0 – 7.0.
$
$
$
0
0
9.6 Total Funding: (Line 9.1 through Line 9.5 = Line 8.3)
9.6 $
0
$
$
10.0 Support Services/Flexible Funding Birth to Age Five Project
School districts must have an approved Birth to Age Five SPED program
application and final report on file at NDE in order to receive payment for
support service/flex funding.
0
10.1 Support Services/Flex Funding Total
10.1 $
$
$
SPED-FFR
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NDE (06-025)
Return to:
SPECIAL EDUCATION
Nebraska Department of Education
Revised 07/2017
AND SUPPORT SERVICES
Date Due: October 31
Financial Services
FINAL FINANCIAL REPORT
P.O. Box 94987
FOR CHILDREN WITH DISABILITIES BIRTH TO AGE FIVE
Lincoln, NE 68509-4987
School Year
2017-2018
PREVIOUS PAGE
County Name
County/District Number
District Name
County Number and Name
Service Ageny Codes & Rates
CONTRACTED SERVICES AGENCIES AND INDIVIDUAL PROVIDERS
(Attach billings; failure to do so may jeopardize payment.)
(A)
(B)
(C)
(D)
(E)
Contracted Service Agency
Line No.
School District/
Service
Amount
Name or Individual Provider
Page 2
Agency Code
Code
Claimed
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0
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- 3 -
Return to:
NDE (06-025)
SPECIAL EDUCATION
Nebraska Department of Education
Revised 07/2017
AND SUPPORT SERVICES
Date Due: October 31
Financial Services
FINAL FINANCIAL REPORT
P.O. Box 94987
FOR CHILDREN WITH DISABILITIES BIRTH TO AGE FIVE
Lincoln, NE 68509-4987
PREVIOUS PAGE
School Year
2017-2018
County Name and Number
County/District Number
District Name
County Number and Name
TUITION RECEIVED FROM CONTRACTING DISTRICT
SUPPLEMENTARY REPORT OF EXPENDITURES
- Complete this section if an entry was made on Line 8.2a
A
B
C
D
E
Indicate Type of Staff
Identify Amount of
Contracting District
Total
According to Following
Salary Paid to Each
List Names of Personnel Paid
Identification:
Individual (Subtotal
(Last name first, first name and middle initial)
NDE Staff ID Number
FTE
1. Professional
for each type of
County No./District No.
FTE
Tuition
2. Paraprofessional
service)
Amount
3. Clerical
4. Substitute(s)
5. Educational Sign
Language Interpreter
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
0
0
0.00
Total
SPED-FFR
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- 4 -
ADDITIONAL SUPPLEMENTARY
Return to:
NDE (06-025)
SPECIAL EDUCATION
Nebraska Department of Education
Revised 07/2017
AND SUPPORT SERVICES
Date Due: October 31
Financial Services
FINAL FINANCIAL REPORT
P.O. Box 94987
FOR CHILDREN WITH DISABILITIES BIRTH TO AGE FIVE
Lincoln, NE 68509-4987
PREVIOUS PAGE
School Year
2017-2018
County Name and Number
County/District Number
District Name
County Number and Name
TUITION RECEIVED FROM CONTRACTING DISTRICT
SUPPLEMENTARY REPORT OF EXPENDITURES
- Complete this section if an entry was made on Line 8.2a
A
B
C
D
E
Indicate Type of Staff
Identify Amount of
Contracting District
Total
According to Following
Salary Paid to Each
List Names of Personnel Paid
Identification:
Individual (Subtotal
(Last name first, first name and middle initial)
NDE Staff ID Number
FTE
1. Professional
for each type of
2. Paraprofessional
service)
County No./District No.
FTE
Tuition
3. Clerical
Amount
4. Substitute(s)
5. Educational Sign
Language Interpreter
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staff
Type of Staffl
Type of Staff
Type of Staff
0
Total
SPED-FFR
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- 4 -
ADDITIONAL SUPPLEMENTARY
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