LEA Name

National Center for 

Education Statistics 

(NCES) District 

Identification Number

SY 2009-2010 

Aggregate 

Expenditures

SY 2010-2011 

Aggregate 

Expenditures*

SY 2011-2012 

Aggregate 

Expenditures

Difference 

2011-2012 

vs. SY 2010-

2011

Percentage 

2011-2012 vs. 

SY 2010-2011

SY 2009-2010 

Per-pupil 

Expenditures**

SY 2010-2011 

Per-pupil 

Expenditures**

SY 2011-2012 

Per-pupil 

Expenditures**

Difference 

2011-2012 

vs. SY 2010-

2011

Percentage 

2011-2012 vs. 

SY 2010-2011

Percentage Reduction of 

Covered Program if MOE 

Waiver Request Denied 

Sample LEA 9999999 $1,000,000 $1,100,000 $950,000 -$150,000 -13.64% $8,000 $8,050 $6,800 -$1,250.00 -15.53% -4.04%

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

$0 #DIV/0! $0.00 #DIV/0! #DIV/0!

**If an LEA calculates MOE using more than one per-pupil measure (i.e., enrollment, 

membership, or attendance), provide the data for the per-pupil measure on which the LEA 

came closest to maintaining effort.)

Form 1: Local Educational Agency (LEA) Expenditure Data

*The comparison year expenditures (SY 2010-2011) are equal to actual SY 2010-2011 expenditures unless the LEA failed 

to maintain effort in SY 2010-2011. For an LEA that did not maintain effort in SY 2010-2011, report 90 percent of the SY 

2009-2010 figure in the SY 2010-2011 column in accordance with section 9521(b)(2) of ESEA.

OMB Number: 1810-0693

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB 

control number for this information collection is 1810-0693. The time required to complete this information collection is estimated to average 8 hours per response, including the time to review 

instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) 

or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4536. If you have comments or concerns regarding the status of your individual 

submission of this form, write directly to: Todd Stephenson, Office of Elementary and Secondary Education, U.S. Department of Education, 400 Maryland Avenue, S.W., 3C118, Washington, D.C. 

20202. 
LEA Name

National Center for 

Education Statistics 

(NCES) District 

Identification Number

Local SY 

2009-2010 

Revenue

State SY 

2009-2010 

Revenue

SY 2009-2010 

Non-revenue 

Receipts

SY 2009-

2010 Total

Local SY 

2010-2011 

Revenue

State SY 

2010-2011 

Revenue

SY 2010-2011 

Non-revenue 

Receipts

SY 2010-

2011 Total

Local SY 

2011-2012 

Revenue

State SY 

2011-2012 

Revenue

SY 2011-2012 

Non-revenue 

Receipts

SY 2011-2012 

Total

$ Difference 

SY 2011-2012 

vs. SY 2010-

2011

% Difference 

SY 2011-2012 

vs. SY 2010-

2011

Sample LEA 9999999 $500,000 $500,100 $5,000 $1,005,100 $550,000 $600,000 $5,600 $1,155,600 $420,000 $530,000 $0 $950,000.00 -$205,600.00 -17.79%

Form 2: Local Educational Agency (LEA) Revenue Data
LEA Name

National Center for 

Education Statistics 

(NCES) District 

Identification Number Explanation of why LEA did not maintain effort*

Sample LEA 9999998

Form 3: Explanation 

*Section 9521(c) of the ESEA gives the Secretary the authority to waive the ESEA's MOE requirement for an LEA if it would 

be equitable to grant the waiver due to an exceptional or uncontrollable circumstance such as a natural disaster or a 

precipitous decline in the LEA's financial resources.