California Department of Education Significant Disproportionality

Special Education Division Coordinated Early Intervening Services Plan

2014 Expenditure Report—Page 1 of 2

2014 Significant Disproportionality Coordinated Early Intervening Services Expenditure Report
Local Educational Agency:______County-District-School Code:______
Grant Award Period: July 1, 2014, through September 30, 2016
2014 Significant Disproportionality Coordinated Early Intervening Services (SD-CEIS) funds must be expended by September 30, 2016.
Due Dates: Reports are due to the California Department of Education (CDE) 30 days after the ending date of each reporting period.
Check appropriate box for Expenditure Report period being submitted:
Report 1: July 1, 2014, to December 31, 2014 / Report 4: July 1, 2015, to September 30, 2015 / Report 7: June 1, 2016, to September 30, 2016
Report 2: January 1, 2015, to March 31, 2015 / Report 5: October 1, 2015, to January 30, 2016 / Final Report: All 2014 SD-CEIS funds have
been expended
Report 3: April 1, 2015, to June 30, 2015 / Report 6: February 1, 2016, to May 30, 2016
Instruction: Provide the total dollar amount for each resource code listed below. The amounts entered for the SD-CEIS allocation resource codes must match the amounts reported on Budget Reporting Form One.
Fiscal Year 2014–15 Allocation Resource Codes: / 3310 / $ / 3315 / $ / 3320 / $
SD-CEIS Resource Codes (15% of the Allocation Resource Codes): / 3312 / $ / 3318 / $ / 3332 / $
Resource Code 3312
Budget Line Items / Column A / Column B / Column C / Column D / Column E / Column F
Brief Description of Expenditures / 2014
Resource Code 3312 Budget / Current Period Expenditures / Prior Reported
Expenditures / Year-to-date Expenditures
(C+D) / Year-to-date Balance
(B–E)
1a. / 1000–Certified Salaries
2a. / 2000–Classified Salaries
3a. / 3000–Employee Benefits
4a. / 4000–Materials/Supplies
5a. / 5000–Service and Other
Operating Costs
6a. / Total Direct Costs (Sum 1a–5a)
7a. / 7300–Indirect Costs
(at CDE approved rate of ___ %)

California Department of Education Significant Disproportionality

Special Education Division Coordinated Early Intervening Services Plan

2014 Expenditure Report—Page 1 of 2

8a. / Total 3312 Program Budget (Sum of 6a–7a)
Resource Code 3318
Budget Line Items / Column A / Column B / Column C / Column D / Column E / Column F
Brief Description of Expenditures / 2014
Resource Code 3318 Budget / Current Period Expenditures / Prior Reported
Expenditures / Year-to-date Expenditures
(C+D) / Year-to-date Balance
(B–E)
1b. / 1000–Certified Salaries
2b. / 2000–Classified Salaries
3b. / 3000–Employee Benefits
4b. / 4000–Materials/Supplies
5b. / 5000–Service and Other
Operating Costs
6b. / Total Direct Costs (Sum 1b–5b)
7b. / 7300–Indirect Costs
(at CDE approved rate of ___ %)
8b. / Total 3318 Program Budget (Sum of 6b–7b)
Resource Code 3332
Budget Line Items / Column A / Column B / Column C / Column D / Column E / Column F
Brief Description of Expenditures / 2014
Resource Code 3332 Budget / Current Period Expenditures / Prior Reported
Expenditures / Year-to-date Expenditures
(C+D) / Year-to-date Balance
(B–E)
1c. / 1000–Certified Salaries
2c. / 2000–Classified Salaries
3c. / 3000–Employee Benefits
4c. / 4000–Materials/Supplies
5c. / 5000–Service and Other
Operating Costs
6c. / Total Direct Costs (Sum 1c–5c)
7c. / 7300–Indirect Costs
(at CDE approved rate of ___ %)
8c. / Total 3332 Program Budget (Sum of 6c–7c)

By signing this form, the authorized agents validate the accuracy of the information reported:

Printed Name of Authorized Agent: / Authorized Agent Title: / Date:
Authorized Agent Signature: / Phone: / E-mail:
Special Education Local Plan Area (SELPA) Code: / SELPA Name: