SB 740 Funding Determination Form

(Based on prior year data.  See instructions for clarification.)

 

I.  Charter Information

Charter School  __________________________________  Charter Number  __________

Address  ________________________________________________________________

Contact Name/Title  _______________________________________________________

Phone Number  _______________________  Fax Number  _______________________

E-mail  __________________________________________________________________

Percentage funding requested  ______________________________________________

Number of years of request (no more than 5 years)  ______________________________

Date charter granted  ______________________________________________________

Date charter terminates (prior to renewal)_______________________________________

 

 

II.  Certification

      I certify that:

  1. The information provided is true and correct to the best of my ability and knowledge.
  2. This charter school’s nonclassroom-based instruction is conducted for and substantially dedicated to the instructional benefit of the school’s students.
  3. This charter school’s governing board has adopted and implements conflict of interest policies.
  4. All of the charter school’s transactions, contracts, and agreements are in the best interest of the school and reflect a reasonable market rate for all goods, services, and considerations rendered for or supplied to the school.

 

Signature of Authorized Individual  _________________________________________

 

Title of Authorized Individual  ______________________________________________

 

Date  __________________________

 

 

SB 740 Funding Determination Form

(Based on prior year data.  See instructions for clarification.)

 

III.  Financial Information

A.                             Resources Available for Expenditure

1.      Revenues and Other Financing Sources

1a.  Federal Revenue

1a(i).  Amount of start-up, implementation, and dissemination grants in 1a.  [$                                    ]

1b.  State Revenue

1c.  Local Revenue

1c(i).  Amount of in-lieu property taxes in 1c.  [$                ]

1d.  Other Financing Sources

1e.  Subtotal (Lines A.1.a through A.1.d)

$

 

 

$

$

 

$

$

2.      Ending Balance From Prior Fiscal Year

$

3.      Total Resources Available for Expenditure (Lines A.1.e and A.2)

$

B.                            Expenditures and Other Financing Uses

1.  Instruction and Related Services

1a.  Salaries and Benefits:

·        Certificated

·        Classified

1b.  Books, Supplies, and Equipment

1c.  Services and Other Operating Costs

·        Contracts for Instructional Services

·        Contracts for Instructional Support

·        All Other Instruction and Related Services and Other Operating Costs

1d.  Subtotal (Lines B.1.a through B.1.c)

 

$

$

$

 

$

$

$

$

$

2.      Operations and Facilities

2a.  Salaries and Benefits:

·        Certificated

·        Classified

2b.  Books, Supplies, and Equipment

2c.  Services and Other Operating Costs

2d.  Facilities Acquisition and Construction

2e.  Subtotal (Lines B.2.a through B.2.d)

2e(i).      Amount of 2.a through 2.c for classrooms and instruction-related space:  [$                          ]

2e(ii).    Amount of 2.a through 2.c for nonclassroom and noninstruction-related space:  [$                              ]

 

$

$

$

$

$

$

 

 

SB 740 Funding Determination Form

(Based on prior year data.  See instructions for clarification.)

 

III.  Financial Information (continued)

 

3.      Administration and All Other Activities

3a.  Salaries and Benefits:

·        Certificated

·        Classified

3b.  Books, Supplies, and Equipment

 

$

$

$

3c.  Services and Other Operating Costs

·        Contracts for Administrative Services

·        Supervisorial Oversight Fee

·        All Other Administration and Other Activities Services and Operating Costs

3d.  Subtotal (Lines B.3.a through B.3.c)

 

$

$

$

$

$

4.      Other Outgo and Other Financing Uses

$

4a.  Debt Service

4b.  Transfers to District or County

4c.  All Other Outgo

4d.  Subtotal (Lines B.4.a through B.4.c)

$

$

$

$

5.      Total Expenditures/Other Uses (Lines B.1.d, B.2.e, B.3.d, B.4.d)

$

C.                            Excess (Deficiency) of Revenues Over Expenditures

1.      Total Excess Revenues (Subtract Line B.5 from Line A.3)

$

1a.  Reserve Required by Charter-authorizing Agency

1b.  Reserve for Facilities Acquisition or Construction

1c.  General Reserve/Designated for Economic Uncertainties

1d.  Other Reserves

$

$

$

$

 

SB 740 Funding Determination Form

(Based on prior year data.  See instructions for clarification.)

 

IV.  Additional Required Information

1.  Provide the charter school’s pupil-teacher ratio as calculated pursuant to Education Code Section 51745.6.  Provide the pupil-teacher ratio of the largest unified school district in the county or counties in which the charter school operates, as required by California Code of Regulations, Title 5, Section 11704.

2.  Provide a listing of entities that received $50,000 or more of the charter school’s total expenditures reported in Section II, Lines B.1.c, B.2.c, and B.3.c, and the amount provided to each.  Are each of the contract payments made by the charter school based on specific services rendered, clearly stating the fee per service rendered and invoiced accordingly?  Are any of the contract payments based upon an amount per unit of average daily attendance or some other percentage of the charter school’s revenues, enrollment, etc.?  If so, which ones?

3.  Who are the members comprising the charter school’s governing board (i.e. how many parents, teachers, etc)?  Describe how those members are selected.  Does the charter school’s governing board have adopted and implemented conflict of interest policies and procedures?  Are any of the governing board members affiliated in any way with any of the entities reported as a response to question 2.  If so, how?

4.  Explain the reasons for the expenditures reported in Section III, Line B.4.b.

  1. List the “Other Reserves” and the amount of each reported on Line C.1.d (if applicable).
  2. What is the total square footage of the facilities occupied by the charter school?  How much of that total is used for instruction and instruction-related purposes?  What percentage of the charter school’s nonclassroom-based pupils use the instructional and instructional-related space?  How frequently is that space used by the charter school’s nonclassroom-based pupils (i.e. how many hours per day, days per week, etc.)?