Instructions for Form Completion

PDE-4507 Individual Data for Nonresident Students in Private Homes in accordance with Section 1305 of School Code

1. The PDE-4507 is an optional form; it has been designed and provided as a service to local education agencies (LEA) that should use this or a similar form to meet Auditor General audit requirements. These instructions are written as if the PDE- 4507 will be used. This form, along with letters from placing agencies and other back-up data for each school year, should be retained in LEA files for audit purposes.
   
   Data reported on this form should be used to report days enrolled/membership in the Pennsylvania Information Management System (PIMS) “Student Calendar Fact” file. These students will have either Residency Status code B (1305, Nonresident foster child, resident foster parent) or Residency Status code C (1305, Nonresident foster child, non-resident foster parent) in field #7 in the “Student Calendar Fact” file. 
    
   
2. Complete the PDE-4507 form. 
   
   Prepare a separate PDE-4507 for each different Calendar ID. Since membership data is uploaded in PIMS in the “Student Calendar Fact” file, it is suggested that data be organized by Calendar ID (field #3) in the “School Calendar” file. Complete heading information: Local Education Agency Name, School Year, Calendar ID, and Days in Session. 
     
   
3. COLUMN INSTRUCTIONS
   Student Name: List the name of each nonresident student placed in a private home who is being educated in accordance with Section 1305 of the “Pennsylvania Public School Code of 1949.” 
   
   
   NOTE: Section 1305 of the “Pennsylvania Public School Code of 1949” provides for the education of a nonresident child placed in the home of a resident, such resident being compensated for keeping the child. LEAs should obtain a statement from the placing agency that the foster parent is receiving compensation and retain this information for review by auditors. This information should be updated each school year to verify residency status. 
   
   
   Current Grade Level: Report the current grade level in which the student was educated. 
   
   
   Name and Address of Resident (Foster Parent) With Whom Child is Placed: Report the name and address of the resident (foster parent) with whom the nonresident child lived during the school year. 
   
   
   Name, Address, and Resident School District of Custodial Parent or Guardian: Report the name and address of the custodial parent or guardian and the name of the resident school district. 
   
   
   NOTE: If the foster placement agency is unwilling to provide this information because of confidentiality concerns, a letter from the placement agency will be acceptable for audit purposes. The letter should indicate that the name, address, and resident school district of the custodial parent cannot be provided because of confidentiality concerns and that the child’s custodial parent or guardian does not reside in the foster school district. 
   
   
   Name and Address of Placing Agency: Report the name and address of the agency placing the student in the private home. 
   
   
   Aggregate Days Enrolled: Report the aggregate days enrolled (membership) for each student listed. The Days Enrolled (field #8) will be uploaded in the PIMS “Student Calendar Fact” file.
   
   
   
   NOTE: If a foster parent’s school district contracts with another school district, an intermediate unit, or a career technology center to provide educational services to Section 1305 nonresident foster children, then the foster parent’s school district is responsible for completing the PDE-4507 and should provide a copy plus back-up documentation to the educating LEA.