Blank Indiana State 51804 PDF Form

Blank Indiana State 51804 PDF Form

The Indiana State 51804 form, also known as the Career College Student Assurance Fund Quarterly Collection (CCSAF-1), is a crucial document for postsecondary proprietary institutions in Indiana. This form is used to report quarterly tuition earnings and calculate the required contributions to the Career College Student Assurance Fund, ensuring protection for students who may experience loss or damage. To comply with state regulations, complete the form accurately and submit it along with the necessary payment.

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The Indiana State Form 51804, officially known as the Career College Student Assurance Fund Quarterly Collection form, serves a critical function in the oversight of proprietary educational institutions within the state. This form is essential for ensuring that these institutions contribute to a fund designed to protect students from financial losses incurred due to specific adverse events. Each campus location must submit a separate form, detailing key information such as the total gross tuition earned from both in-state and out-of-state students, as well as any refunds issued. The form requires precise calculations to determine the required contributions, which include a small percentage of net tuition and a fixed additional fee. Timeliness is crucial, as payments are due within 45 days following the close of each quarterly reporting period. Institutions must adhere to strict guidelines and provide accurate information to avoid potential penalties, including the risk of losing accreditation. For those responsible for completing the form, clear instructions are provided to facilitate compliance, ensuring that all necessary data is captured effectively.

Document Sample

CAREER COLLEGE STUDENT ASSURANCE FUND

FOR OFFICE USE ONLY

QUARTERLY COLLECTION (CCSAF-1)

Date stamp upon receipt (month, day, year)

State Form 51804 (R2 / 6-11)

 

Approved by State Board of Accounts, 2011

 

INSTRUCTIONS: 1. Please print legibly or type the information on this form.

2.A separate form is required for each campus location.

3.Payment is due forty-five (45) days from the close of the quarterly reporting and collection period.

4.Send the completed form and FUND payment to the Indiana Commission on Proprietary Education, 302 West Washington Street, Room E201, Indianapolis, Indiana 46204.

5.If you have any questions concerning this form, please contact the Commission at (317) 232-1320.

SECTION A - REPORTING INFORMATION

1.

COPE advertising code

2. Reporting quarter (check appropriate box)

July 1 - September 30

 

3. Year of reporting quarter

 

 

 

January 1 - March 31

April 1 - June 30

October 1 - December 31

 

 

 

 

 

 

 

 

 

 

 

4.

Name of contact person (person responsible for completing this form)

 

 

 

5. Daytime telephone number

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION B - OWNER INFORMATION

 

 

 

1.

Name of owner (legal, partnership, corporate, or other entity name)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

If sole owner (last name, first name, middle initial, suffix)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Primary address (number and street, city, state, and ZIP code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

E-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C - CAMPUS INFORMATION

 

 

 

1.

Business trade name / DBA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Physical address (number and street, city, state, and ZIP code - no PO Box numbers)

 

 

 

 

 

 

 

 

 

 

 

 

3. Telephone number of business location

 

 

4. Fax number of business location

 

 

 

 

(

)

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION D - REPORT OF QUARTERLY EARNED TUITION

 

 

 

 

1. Total Gross Tuition / Instructional fees received from all Indiana residents this quarter:

 

 

 

 

 

 

 

 

 

 

 

2. Total Gross Tuition / Instructional fees received from all out of state residents instructed within Indiana this quarter:

 

 

 

 

 

 

 

 

 

 

 

3. Total value of refunds made this quarter (to students from, or instructed in, Indiana):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. Net tuition earned (Lines D1 + D2 - D3):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION E - CALCULATION OF REQUIRED CONTRIBUTION

 

 

 

 

1. Required FUND Contribution (0.1% Net Tuition; Line D4 X .001):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Additional Required Fee (IC 21-17-3-9):

 

 

 

 

 

 

$60.00

 

 

 

 

 

 

 

 

 

 

3. Total Payment this quarter (Lines E1 + E2):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION F - SIGNATURE AND CERTIFICATION OF NOTARY PUBLIC

 

 

 

 

STATE OF _______________________________

 

 

 

 

 

 

 

 

 

 

SS:

 

 

 

 

 

 

 

 

COUNTY OF _____________________________

 

 

 

 

 

 

 

 

I, ________________________________________________________________, first being duly sworn on oath say that I am the above named,

 

that I have personally prepared the foregoing application, and that the same is true to the best of my knowledge and belief.

 

 

 

 

 

 

 

 

 

Signature of person completing this form

 

 

 

 

Date subscribed and sworn (month, day, year)

 

 

 

 

 

 

 

 

 

Printed or typed name of person completing this form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of notary public

 

 

Printed or typed name of notary public

 

 

 

 

 

 

 

 

 

 

 

County of residence

 

 

Date commission expires (month, day, year)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSTRUCTIONS FOR COMPLETING STATE FORM 51804, CAREER COLLEGE STUDENT ASSURANCE FUND QUARTERLY COLLECTION (CCSAF-1)

INSTRUCTIONS FOR COMPLETING STATE FORM 51804 & SUBMITTING PAYMENT TO THE FUND

All sections of the form must be completed.

Purpose: The career college student assurance fund is established to provide indemnification to a student or an enrollee of a postsecondary proprietary institution who suffers loss or damage as a result of any of the occurrences described in section 5(c) of IC 21-17.

State Form 51804 is used to calculate and process quarterly payments to the Career College Student Assurance Fund as directed under IC 21-17-3-9 and 570 IAC, the statute and regulations of the Indiana Commission on Proprietary Education.

This form and the required payment must be submitted quarterly in accordance with IC 21-17-3-9 and 570 IAC 1-14.

A completed form and payment is required of each campus for which a surety bond is required for accreditation.

Section D (Report of Quarterly Earned Tuition) pertains to all students who are residents of Indiana - regardless of instructional location - and all students instructed within the state of Indiana. The annual (four-quarter) totals from Line D1 and Line D2 should be comparable to the values reported on the Indiana Tuition Report (State Form 49926).

Payment of the Additional Required Fee (Line E2) is required every quarter as defined in IC 21-17-3-9 et seq. If no tuition revenue is collected, or if the FUND has reached maturity, please remit ONLY this amount.

Failure to remit the appropriate fee(s) may result in the suspension or revocation of institutional accreditation to operate as a postsecondary proprietary institution within the state of Indiana.

Be sure to answer all applicable questions. Failure to do so may result in delays in crediting your account. Please print legibly or type the information on your application.

Payment is due forty-five (45) days from the close of the quarterly reporting and collection period.

Send the completed form and payment to the Indiana Commission on Proprietary Education, 302 West Washington Street, Room E201, Indianapolis, Indiana 46204.

If you have any questions concerning this form, please contact the Commission at (317) 232-1320.

LAWS & REGULATIONS REGARDING CONTRIBUTIONS TO THE CAREER COLLEGE STUDENT ASSURANCE FUND

STATUTORY AUTHORITY & AGENCY REGULATIONS REGARDING CONTRIBUTIONS TO THE CAREER COLLEGE STUDENT ASSURANCE FUND

(Full texts of the Indiana Code and Indiana Administrative Code are available on the Commission’s web site, www.in.gov/cope.)

IC 21-17-3-9 Quarterly contributions to fund; determination; bond

Sec. 9.3. (a) Subject to section 9(a) of this chapter, each postsecondary proprietary educational institution shall make quarterly contributions to the fund. The quarters begin January 1, April 1, July 1, and October 1.

(b)For each quarter, each postsecondary proprietary educational institution shall make a contribution equal to the STEP THREE amount derived under the following formula:

STEP ONE: Determine the total amount of tuition and fees earned during the quarter.

STEP TWO: Multiply the STEP ONE amount by one-tenth of one percent (0.1%).

STEP THREE: Add the STEP TWO amount and sixty dollars ($60).

(c)Notwithstanding section 6 of this chapter, for a postsecondary proprietary educational institution commencing operation after

September 30, 2004, the commission, in addition to requiring contributions to the fund, shall require the postsecondary proprietary institution to submit a surety bond in an amount determined by the commission for an amount of time that represents the number of quarters required for the fund to initially accumulate one million dollars ($1,000,000) as determined under section 6 of this chapter.

570 IAC 1-14 Career College Student Assurance Fund

570 IAC 1-14-3 Fund contributions

Sec. 3. (a) The proper amount of a postsecondary educational institution’s fund contribution shall be calculated in accordance with IC 21-17-3-9.

(b)Upon receipt of a contribution from a school to the fund, the check shall be deposited into the fund within twenty-four (24) hours of receipt.

(c)Money in the fund not currently needed will be invested by the treasurer of the state.

(d)The treasurer of the state shall invest the money in a manner similar to the investment of other public funds.

(e)Any gains made from fund investments shall also be deposited into the fund.

(f)Fund proceeds do not revert into the general state fund.

570 IAC 1-14-4 Quarterly contributions

Sec. 4. Each postsecondary proprietary institution shall make quarterly contributions to the fund in compliance with IC 21-17-3-9. As used in IC 21-17-3-9, “total amount of tuition and fees” means gross income before depreciation, taxes, or amortization, less any student refunds required by this rule or by student contract.

570 IAC 1-14-5 Quarterly beginnings

Sec. 5. A new quarter will begin on each of the following dates:

(1)January 1.

(2)April 1.

(3)July 1.

(4)October 1.

File Specifics

Fact Name Details
Form Purpose The Indiana State Form 51804 is used for quarterly contributions to the Career College Student Assurance Fund, which provides financial protection for students of proprietary institutions.
Submission Deadline Payment and the completed form must be submitted within 45 days after the end of the quarterly reporting period.
Governing Laws This form is governed by Indiana Code IC 21-17-3-9 and regulations under 570 IAC.
Campus Requirement A separate Form 51804 is required for each campus location of a proprietary institution.

How to Use Indiana State 51804

Filling out the Indiana State Form 51804 is a straightforward process. Each campus location must submit a separate form to ensure compliance with state regulations. The form requires detailed reporting of tuition earnings and contributions to the Career College Student Assurance Fund. It is essential to complete all sections accurately and submit the form along with the required payment within the specified timeframe.

  1. Print or type the required information clearly on the form.
  2. Complete Section A - Reporting Information:
    • Enter the COPE advertising code.
    • Select the reporting quarter by checking the appropriate box.
    • Fill in the year of the reporting quarter.
    • Provide the name of the contact person responsible for the form.
    • Include the daytime telephone number.
  3. Fill out Section B - Owner Information:
    • Enter the name of the owner (legal, partnership, corporate, or other entity).
    • If a sole owner, provide the last name, first name, middle initial, and suffix.
    • List the primary address (number and street, city, state, and ZIP code).
    • Include an email address.
  4. Complete Section C - Campus Information:
    • Enter the business trade name / DBA.
    • Provide the physical address (number and street, city, state, and ZIP code - no PO Box numbers).
    • List the telephone number of the business location.
    • Include the fax number of the business location.
  5. Fill out Section D - Report of Quarterly Earned Tuition:
    • Enter the total gross tuition/instructional fees received from all Indiana residents this quarter.
    • Enter the total gross tuition/instructional fees received from all out-of-state residents instructed within Indiana this quarter.
    • List the total value of refunds made this quarter (to students from, or instructed in, Indiana).
    • Calculate and enter the net tuition earned (Lines D1 + D2 - D3).
  6. Complete Section E - Calculation of Required Contribution:
    • Calculate the required FUND contribution (0.1% of net tuition; Line D4 X .001).
    • Enter the additional required fee ($60.00).
    • Calculate and enter the total payment this quarter (Lines E1 + E2).
  7. In Section F - Signature and Certification of Notary Public:
    • Sign and date the form.
    • Print or type the name of the person completing the form.
    • Have the signature of a notary public and include their printed or typed name.
    • Provide the county of residence and the date the notary's commission expires.
  8. Submit the completed form and payment to the Indiana Commission on Proprietary Education at the specified address.

Your Questions, Answered

What is the purpose of the Indiana State 51804 form?

The Indiana State 51804 form, also known as the Career College Student Assurance Fund Quarterly Collection form, is designed to help postsecondary proprietary institutions report and pay contributions to the Career College Student Assurance Fund. This fund provides financial protection to students who may experience losses due to certain circumstances defined by Indiana law. Completing this form is a requirement for institutions to maintain their accreditation.

Who needs to complete the Indiana State 51804 form?

Every postsecondary proprietary institution operating in Indiana must complete this form for each campus location. This includes any institution that is required to have a surety bond for accreditation. If an institution has multiple campuses, a separate form must be submitted for each one.

When is the payment due for the contributions reported on this form?

Payments are due forty-five (45) days after the end of each quarterly reporting period. The quarters are defined as follows:

  1. January 1 - March 31
  2. April 1 - June 30
  3. July 1 - September 30
  4. October 1 - December 31

Timely submission is crucial to avoid penalties or issues with accreditation.

What information is required on the form?

Several sections need to be filled out, including:

  • Reporting Information: Details about the quarter and contact person.
  • Owner Information: Name and address of the institution’s owner.
  • Campus Information: Business name and physical address.
  • Report of Quarterly Earned Tuition: Total tuition collected and refunds issued.
  • Calculation of Required Contribution: This includes the net tuition earned and the total payment due.

It is essential to complete all sections accurately to ensure smooth processing.

What happens if the form is not submitted on time?

Failure to submit the Indiana State 51804 form and the corresponding payment by the deadline can lead to serious consequences. This may include the suspension or revocation of the institution's accreditation to operate within Indiana. It is vital to adhere to the deadlines to maintain compliance and avoid disruptions.

Where should the completed form be sent?

Once the form is completed, it should be sent along with the payment to the following address:

Indiana Commission on Proprietary Education
302 West Washington Street, Room E201
Indianapolis, Indiana 46204

For any questions regarding the form or the process, you can contact the Commission at (317) 232-1320.

Common mistakes

  1. Illegible handwriting: Filling out the form in a way that is hard to read can lead to processing delays. Always print legibly or type your information.

  2. Missing campus information: Each campus location requires a separate form. Failing to submit one for each campus can cause issues with compliance.

  3. Late submissions: Payment is due forty-five days after the reporting period ends. Late submissions may result in penalties or loss of accreditation.

  4. Incorrect tuition calculations: Ensure that the total gross tuition and instructional fees are accurately reported. Mistakes here can affect your required contribution.

  5. Omitting contact details: Always include the name and daytime phone number of the person responsible for the form. This information is crucial for follow-up.

  6. Inaccurate owner information: Provide the correct legal name of the owner or entity. Errors can complicate the verification process.

  7. Not signing the form: Ensure that the person completing the form signs it. An unsigned form may be deemed incomplete.

  8. Ignoring refund values: Report any refunds made during the quarter accurately. This affects the net tuition calculation.

  9. Neglecting notary requirements: If required, ensure that a notary public signs and stamps the form. Missing this step can invalidate your submission.

Documents used along the form

When dealing with the Indiana State Form 51804, several other forms and documents may be necessary to ensure compliance and proper reporting. Each of these documents serves a specific purpose in the overall process of managing contributions to the Career College Student Assurance Fund.

  • Indiana Tuition Report (State Form 49926): This report provides a comprehensive overview of tuition and fees collected from students. It is essential for cross-referencing the figures reported on the 51804 form, ensuring that all data is accurate and consistent.
  • Surety Bond Documentation: For newly established postsecondary proprietary institutions, a surety bond is required. This document guarantees that the institution can meet its financial obligations to the Career College Student Assurance Fund, providing additional security for students.
  • Payment Receipt Confirmation: After submitting the 51804 form and payment, institutions should keep a copy of the payment receipt. This serves as proof of compliance and can be useful in case of any discrepancies or audits.
  • Quarterly Financial Statements: These statements provide a detailed account of the institution's financial activities for the quarter. They help in calculating the required contributions and can support the figures reported on the 51804 form.
  • Notary Public Certification: This certification is necessary for the signature section of the 51804 form. It verifies the identity of the individual completing the form and ensures the authenticity of the submission.

Understanding these accompanying documents is crucial for institutions to maintain compliance with state regulations. Proper management of these forms not only supports accurate reporting but also helps protect the interests of students enrolled in proprietary educational programs.

Similar forms

The Indiana State Form 51804 is similar to the Federal Form 990, which is used by tax-exempt organizations to report financial information to the IRS. Both forms require organizations to disclose their revenue and expenses, ensuring transparency in financial operations. Just as the 51804 form requires career colleges to report tuition earnings, Form 990 compels organizations to provide details about their income sources, including donations and grants. This parallel emphasizes accountability and helps maintain public trust in educational institutions and non-profit organizations alike.

Another comparable document is the IRS Form 941, which employers use to report income taxes, Social Security tax, and Medicare tax withheld from employee wages. Like the 51804 form, Form 941 requires timely submission and accurate reporting of financial data. Both forms serve to ensure compliance with federal and state regulations. Just as the 51804 mandates quarterly tuition reporting, Form 941 necessitates quarterly payroll tax reporting, highlighting the importance of regular financial oversight for organizations.

The Indiana Department of Revenue’s Form IT-40 is also similar, as it is used by individuals to report their state income tax. Both forms require precise calculations of income, deductions, and credits. The IT-40 form, like the 51804, emphasizes the importance of accuracy in reporting financial figures. Both forms are essential for maintaining compliance with state regulations and contribute to the overall financial health of the state’s education and tax systems.

Form 5500, which is used to report information about employee benefit plans, shares similarities with the 51804 form in that both require organizations to provide detailed financial information. The 5500 form ensures compliance with the Employee Retirement Income Security Act (ERISA), while the 51804 ensures compliance with state regulations regarding career colleges. Both forms aim to protect stakeholders by promoting transparency and accountability in financial practices.

The Uniform Financial Report (UFR) used by non-profit organizations in Indiana also bears resemblance to the 51804 form. Both documents require comprehensive reporting of financial activities, ensuring that organizations disclose their revenue sources and expenses. The UFR, like the 51804, is designed to promote transparency and accountability, helping stakeholders understand the financial health of the organization.

Additionally, the Indiana State Form 49926, known as the Tuition Report, is closely related to the 51804 form. Both forms require educational institutions to report tuition revenue, but the 49926 focuses specifically on annual totals rather than quarterly submissions. This connection emphasizes the importance of accurate financial reporting in the education sector, ensuring that institutions maintain compliance with state regulations.

The Federal Student Aid’s Program Participation Agreement (PPA) is another document that aligns with the 51804 form. The PPA outlines the responsibilities of institutions participating in federal student aid programs. Both documents require educational institutions to adhere to specific financial reporting standards and ensure compliance with regulatory requirements. This alignment underscores the shared goal of promoting accountability and transparency in the administration of educational programs.

Finally, the Indiana State Form 132, which is used for the reporting of property tax exemptions, shares similarities with the 51804 form in that both require detailed reporting of financial information to state agencies. Both forms serve to ensure compliance with state laws and regulations, emphasizing the importance of accurate financial reporting in maintaining the integrity of state-funded programs and services.

Dos and Don'ts

When filling out the Indiana State Form 51804, there are important guidelines to follow. Here’s a list of things you should and shouldn’t do:

  • Do print legibly or type the information to ensure clarity.
  • Do submit a separate form for each campus location.
  • Do double-check all calculations to avoid errors in your payment.
  • Do ensure that all applicable sections are completed before submission.
  • Do send the form and payment to the correct address in Indianapolis.
  • Don't use a PO Box for the physical address; it must be a street address.
  • Don't forget that payment is due within 45 days after the quarterly period ends.
  • Don't leave any required fields blank, as this may delay processing.
  • Don't submit the form without verifying your contact information is correct.
  • Don't hesitate to contact the Commission if you have questions about the form.

Misconceptions

Understanding the Indiana State 51804 form can be challenging, and several misconceptions often arise. Here are ten common misunderstandings regarding this form:

  • All campuses can use a single form. Each campus location must submit a separate form. This requirement ensures accurate reporting for each site.
  • Payment is optional if no tuition is collected. Even if no tuition revenue is earned, the additional required fee of $60 must still be submitted each quarter.
  • The form is only for Indiana residents. The form requires reporting on tuition collected from both Indiana residents and out-of-state residents instructed within Indiana.
  • Submission deadlines are flexible. Payment is due 45 days after the close of the quarterly reporting period. Late submissions can lead to penalties.
  • Refunds do not need to be reported. The total value of refunds made during the quarter must be included in the calculations on the form.
  • The form can be filled out in any format. It is essential to print legibly or type the information to ensure clarity and avoid processing delays.
  • There is no need for notarization. The form must be signed and notarized to certify the accuracy of the information provided.
  • All questions on the form are optional. Every applicable question must be answered. Incomplete forms can result in delays in processing.
  • The fund is only for student tuition reimbursement. The Career College Student Assurance Fund provides indemnification for students who suffer losses due to specific occurrences outlined in the regulations.
  • Investments from the fund revert to the general state fund. Any gains from the fund's investments remain within the fund and do not revert to the state's general fund.

By clarifying these misconceptions, institutions can better navigate the requirements associated with the Indiana State 51804 form and ensure compliance with state regulations.

Key takeaways

Key Takeaways for the Indiana State Form 51804

  • Complete all sections of the form accurately, as incomplete submissions can lead to delays.
  • Each campus location must submit a separate form, ensuring compliance with state regulations.
  • Payment is due within 45 days after the end of each quarterly reporting period; be mindful of deadlines.
  • If you have questions, reach out to the Indiana Commission on Proprietary Education at (317) 232-1320 for assistance.