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Instructions for Preparing Form SF-14H
Tuition Certification and Report of Children With Disabilities
in Membership Pursuant to Section 3323.13 and 3323.14 O.R.C.
PURPOSE: |  |  |  |  |  |  |  | Form SF-14H is provided twice annually for the use of each city, exempted village or local
 |  |  |  |  |  |  |  | school district that desires to certify to the Office of Quality School Choice and Funding, Ohio
 |  |  |  |  |  |  |  | Department of Education, the students with disabilities in membership* in the schools
 |  |  |  |  |  |  |  | of their district for which tuition is the obligation of another district in accordance with the
 |  |  |  |  |  |  |  | provisions of 3323.13 and 3323.14 [NAME]  This form is not to be used for open
 |  |  |  |  |  |  |  | enrolled children with disabilities (EMIS Status 9), COOP Arrangements (EMIS
 |  |  |  |  |  |  |  | Status B), DD's, JVSD's, and ESC Contractual Arrangements.  Additionally,
 |  |  |  |  |  |  |  | students are not to be included on this form when the parent unilaterally places a
 |  |  |  |  |  |  |  | child in a residence not defined as a "home" in 3313.64(A)(4) in another district and
 |  |  |  |  |  |  |  | the resident district has offered FAPE (Free Appropriate Public Education)
 |  |  |  |  |  |  |  | pursuant to 3323.143 [NAME]
 |  |  |  |  |  |  |  | Note:  *Membership includes parent-teacher conference days and calamity days.
PROCEDURE: |  |  |  |  |  |  |  | Form SF-14H will be used as a notification form for the district(s) of financial responsibility.
 |  |  |  |  |  |  |  | Calculation of the tuition amount for each student based on the number of membership days
 |  |  |  |  |  |  |  | and daily tuition rate will be performed by the Office of Quality School Choice and Funding.
 |  |  |  |  |  |  |  | Both the district of residence and the educating district will be notified of the amount of the
 |  |  |  |  |  |  |  | tuition credit/deduction for each student in an EMIS report prior to the adjustment being
 |  |  |  |  |  |  |  | made in the succeeding Statement of Settlement.  The maximum number of days
 |  |  |  |  |  |  |  | reportable on the SF-14H is 180 days for both the first and second reporting periods
 |  |  |  |  |  |  |  | combined.
 |  |  |  |  |  |  |  | For new listings:  If a student is placed by the court or other legal authority, and a court
 |  |  |  |  |  |  |  | document or ODE determination exists naming a school district responsible for tuition
 |  |  |  |  |  |  |  | and/or excess cost, the educating district must attach two copies of the document for the
 |  |  |  |  |  |  |  | initial period the student is reported.  If the student is reported initially for the first
 |  |  |  |  |  |  |  | reporting period of the school year, no court document or ODE determination would be
 |  |  |  |  |  |  |  | required to be submitted for the second reporting period of that year or for either
 |  |  |  |  |  |  |  | reporting period of subsequent years as long as the court order or ODE district of
 |  |  |  |  |  |  |  | residence determination initially submitted remains in effect.
 |  |  |  |  |  |  |  | NOTE:  The educating district must also submit the required documentation for Section II
 |  |  |  |  |  |  |  | of the SF-14H as listed on Page 2 of these instructions for the initial period the student is
 |  |  |  |  |  |  |  | reported.  The required documentation must be updated annually and submitted with  the
 |  |  |  |  |  |  |  | SF-14H for the first reporting period of each subsequent school year.
ELIGIBILITY: |  |  |  |  |  |  |  | Each child for whom SF-14H is submitted requires an appropriate individual education
 |  |  |  |  |  |  |  | program.  This is the responsibility of the school district of residence.  However, the district
 |  |  |  |  |  |  |  | of residence has fulfilled its responsibility when agreement is concurred upon after the
 |  |  |  |  |  |  |  | district of attendance has complied with any of the three statements pursuant to Section
 |  |  |  |  |  |  |  | 3323.13 (C) O.R.C. (See Section II on Form SF-14H).  The SF-14H must be completed
 |  |  |  |  |  |  |  | and submitted prior to any determination or collection of excess cost on Form SF-6 for
 |  |  |  |  |  |  |  | students with EMIS Status C, P or T.
PREPARATION: |  |  |  |  |  |  |  | District of Attendance:  Prepare two (2) typewritten copies of Form SF-14H for each
 |  |  |  |  |  |  |  | school district(s) having financial responsibility of children with disabilities in membership in
 |  |  |  |  |  |  |  | your district pursuant to 3323.13 and 3323.14 O.R.C.  The original and one (1) copy of
 |  |  |  |  |  |  |  | the completed Form SF-14H shall be filed with the Regional Coordinator's Office on or before
 |  |  |  |  |  |  |  | March 1 for the first reporting period and on or before August 1 for the second reporting
 |  |  |  |  |  |  |  | period. Corrections to the original filing of Form SF-14H received after April 1 will not be
 |  |  |  |  |  |  |  | accepted for the first reporting period and September 1 for the second reporting period.
 |  |  |  |  |  |  |  | If more spaces are needed, use the Form SF-14H Attachment.
HEADING: |  |  |  |  |  |  |  | When you enter your school district's IRN, the name and county will be filled in for you.
 |  |  |  |  |  |  |  | You will still need to enter the school year and select the correct reporting period.
SECTION I: |  |  |  |  |  |  |  | When you enter the IRN of the district responsible for tuition, the county, district's
 |  |  |  |  |  |  |  | superintendent's name and district's address will be filled in for you.
SECTION II: |  |  |  |  |  |  |  | Affix signatures of superintendent, treasurer and contact person/telephone number/e-mail
 |  |  |  |  |  |  |  | address and dates.
 |  |  |  |  |  |  |  | Check the box in answer to the yes or no questions.
 |  |  |  |  |  |  |  | If the answer is no to all questions, STOP:  Your district is not eligible for tuition or excess
 |  |  |  |  |  |  |  | cost.
 |  |  |  |  |  |  |  | If the answer is yes to any of the three questions, CONTINUE:  However, documented
 |  |  |  |  |  |  |  | evidence must be attached displaying one of the following with an SSID number (No
 |  |  |  |  |  |  |  | students' names are to appear on any SF-14H or SF-14H attachment submitted to
 |  |  |  |  |  |  |  | ODE):
 |  |  |  |  |  |  |  |  | 1. |  | A copy of the signature page of the individual education program displaying the
 |  |  |  |  |  |  |  |  |  |  | parent(s) resident school officials signature and effective date
 |  |  |  |  |  |  |  |  |  |  | OR
 |  |  |  |  |  |  |  |  | 2. |  | A copy of the letter inviting the resident school district official(s) to attend the
 |  |  |  |  |  |  |  |  |  |  | IEP meeting
 |  |  |  |  |  |  |  |  |  |  | OR
 |  |  |  |  |  |  |  |  | 3. |  | A copy of a signed contract between your district and the district of residence,
 |  |  |  |  |  |  |  |  |  |  | OR
 |  |  |  |  |  |  |  |  | 4. |  | A document confirming your district informed the district of residence in writing that
 |  |  |  |  |  |  |  |  |  |  | your district is providing the education for the child.
SECTION III:
 | Column A |  |  |  |  |  |  | Enter the state student identification number of each student with a disability for which
 |  |  |  |  |  |  |  | tuition is requested.
 | Column B |  |  |  |  |  |  | If a student is enrolled for less than a full reporting period, enter the admission (Entry)
 |  |  |  |  |  |  |  | date and/or the withdrawal date.
 | Column C |  |  |  |  |  |  | Refer to Section 3323.01 O.R.C. and 3313.64(C)(3)(a) cited below and enter the number
 |  |  |  |  |  |  |  | (1), (2), (3) or (4)  representing the division of law which determines the school district of
 |  |  |  |  |  |  |  | financial responsibility.
 |  |  |  |  |  |  |  | SECTION 3323.01(M) OHIO REVISED CODE - Select the criteria code applicable for each
 |  |  |  |  |  |  |  | student with a disability whose state student identification number listed in Column A in
 |  |  |  |  |  |  |  | determining the school district responsible for tuition when the child does not live in the
 |  |  |  |  |  |  |  | district where the parent resides.
 |  |  |  |  |  |  |  | Quoted below, in pertinent part, is Division (M) (1) (2) (3) and (4) of Section 3323.01(M)
 |  |  |  |  |  |  |  | O.R.C. "School district of residence" means:
 |  |  |  |  |  |  |  |  | 1. |  | The school district in which the child's natural or adoptive parents reside (See
 |  |  |  |  |  |  |  |  |  |  | also 3313.64(C)(3)(a):
 |  |  |  |  |  |  |  |  | 2. |  | If the school district specified in division (M)(1) of this section cannot be
 |  |  |  |  |  |  |  |  |  |  | determined, the last school district in which the child's natural or adoptive
 |  |  |  |  |  |  |  |  |  |  | parents are known to have resided if the parents' whereabouts are unknown:
 |  |  |  |  |  |  |  |  | 3. |  | If the school district specified in division (M)(2) of this section cannot be
 |  |  |  |  |  |  |  |  |  |  | determined, the school district determined by the court under section 2151.362
 |  |  |  |  |  |  |  |  |  |  | [2151.36.2] of the Ohio Revised Code, or if no district has been so determined,
 |  |  |  |  |  |  |  |  |  |  | the school district as determined by the probate court of the county in which
 |  |  |  |  |  |  |  |  |  |  | the child resides.
 |  |  |  |  |  |  |  |  | 4. |  | Notwithstanding divisions (M)(1) to (3) of this section, if a school district is
 |  |  |  |  |  |  |  |  |  |  | required by section 3313.65 of the Ohio Revised Code to pay tuition for a child,
 |  |  |  |  |  |  |  |  |  |  | that district shall be the child's district of residence.
 | Column D |  |  |  |  |  |  | Enter special education category 1 through 6 for the student listed in Column A as follows:
 |  |  |  |  |  |  |  | Category 1 - Speech and language disability
 |  |  |  |  |  |  |  | Category 2 - Specific learning disabled or developmentally disabled or other health
 |  |  |  |  |  |  |  |  |  |  |  | impairment - minor
 |  |  |  |  |  |  |  | Category 3 - Hearing impaired or emotional disability
 |  |  |  |  |  |  |  | Category 4 - Vision impaired or other health impairment - major
 |  |  |  |  |  |  |  | Category 5 - Orthopedically disabled or as having multiple disabilities
 |  |  |  |  |  |  |  | Category 6 - Autism, traumatic brain injury, or both visually and hearing impaired
 | Column E |  |  |  |  |  |  | Enter the EMIS Status Code for each child listed in Column A as follows:  Parental
 |  |  |  |  |  |  |  | Institution Placement (1T), Court Placed Foster Care (1C), Court Placed Group Home (1P)
 |  |  |  |  |  |  |  | and Nonresident Title I (1W)
 | Column F |  |  |  |  |  |  | Enter the address for each pupil state student identification number listed in Column A
 |  |  |  |  |  |  |  | as determined by the appropriate division of the Ohio Revised Code listed in Column C.
 |  |  |  |  |  |  |  | If (1) is entered in Column C, enter the address at which the child's parent(s) reside.
 |  |  |  |  |  |  |  | If (2) is entered in Column C, enter the address at which the parent(s) were last known
 |  |  |  |  |  |  |  | to have resided in Ohio if the parents whereabouts are unknown.
 |  |  |  |  |  |  |  | If (3) is entered in Column C, enter the "Journal Entry" address and county in which court
 |  |  |  |  |  |  |  | decree was recorded.
 |  |  |  |  |  |  |  | If (4) is entered in Column C, enter address at which the child's parent resided at the time
 |  |  |  |  |  |  |  | of the parent's incarceration, juvenile residential or residential facility placement.
 | Column G |  |  |  |  |  |  | Enter the date of birth for each child's state student identification number listed in Column
 |  |  |  |  |  |  |  | A.
 | Column H |  |  |  |  |  |  | Enter the current grade level for each child's state student identification number listed in
 |  |  |  |  |  |  |  | Column A.
 |  |  |  |  |  |  |  | Grade Level
 |  |  |  |  |  |  |  | Note:  If the child is enrolled in an all-day every day kindergarten program fully funded by the
 |  |  |  |  |  |  |  | district, enter [NAME] in the Grade Level box.*  If the child is enrolled in a half day every day
 |  |  |  |  |  |  |  | program or an all-day every other day program place a [NAME] in the box.
 |  |  |  |  |  |  |  | *If the district charges a student tuition for a portion of the all-day every day program,
 |  |  |  |  |  |  |  | a [NAME] must be entered in the Grade Level box.
 | Column I |  |  |  |  |  |  | Enter the number of days the pupil listed in Column A was enrolled during the
 |  |  |  |  |  |  |  | current reporting period.
 |  |  |  |  |  |  |  | Note:  The number of days a tuition student may be counted is 180 days maximum for
 |  |  |  |  |  |  |  | the first and second reporting periods combined.  COUNT KINDERGARTEN STUDENTS
 |  |  |  |  |  |  |  | enrolled up to 180 days maximum for the first and second reporting periods combined
 |  |  |  |  |  |  |  | regardless of enrollment in a half day or full-day program.
 | Column J |  |  |  |  |  |  | Revised Days
 |  |  |  |  |  |  |  | The reporting district (district of attendance) is responsible for contacting the Regional
 |  |  |  |  |  |  |  | Coordinator's Office with corrections.
 |  |  |  |  |  |  |  | If the error is discovered before thirty (30) days have elapsed, from the date of receipt
 |  |  |  |  |  |  |  | of the Form SF-14H, a letter addressed to the district responsible for tuition advising
 |  |  |  |  |  |  |  | them of the correction is necessary.  A copy of the letter must be sent to the Regional
 |  |  |  |  |  |  |  | Coordinator's Office which will permit them to make corrections to the original Form
 |  |  |  |  |  |  |  | SF-14H.
 |  |  |  |  |  |  |  | To add pupils after the original Form SF-14H has been processed, please complete
 |  |  |  |  |  |  |  | Columns A, B, C, D, E, F, G, H, and I on a new Form SF-14H, and file two (2) copies with
 |  |  |  |  |  |  |  | the Regional Coordinator's Office.
 |  |  |  |  |  |  |  |  | Return original and 1 copy of the SF-14H Form and 2 copies of any
 |  |  |  |  |  |  |  |  | legal documents related to the pupils listed in Column A to: