Official Site of The State of New Jersey

This form must be prepared by the lessor/service provider/vendor (hereafter referred to as “lessor” for convenience) and attached to the applicable service agreement (lease, contract, etc.), with copies of both forwarded to the Department by the APSSD for every year the related party transaction(s) exists. The attached form must include the anticipated costs of ownership, which pertain to any real or personal property leased by the APSSD, or the cost of goods/services provided. For leases, until the lessor provides a final year-end accounting of the actual costs of ownership, the APSSD’s accounting records may only reflect an allowable lease expense of an amount less than or equal to the “Total Lease Amount” shown in column (2) “Allocated to Private School Lease,” on page 3 of this form.

The lease expense or cost associated with a service or purchase agreement that may be included in the certified actual cost per pupil is limited to the final year-end actual costs of ownership incurred by the related party plus a 2.5 percent return on the actual costs of ownership. See N.J.A.C. 6A:23A-18.6(a)(44)(i) and (v). The related party must provide this information to the APSSD.

Please note that if the related party transaction is not a lease, questions on the form related solely to lease agreements or property do not need to be answered. In addition to the form being signed by the lessor, notarized, and made part of the lease, a completed copy of the notarized form along with a copy of the lease or contract, as applicable, must be submitted.

As a reminder, the private school must upload the Prescribed “Cost of Ownership” Format for Related Party Transaction Real and Personal Property form, as well as all other annual APSSD documentation, via APSSD Repository submission. The APSSD Repository is an efficient tool that improved documentation submission to the Division of Finance and Business Services, the Office of Fiscal Policy and Planning. The APSSD Repository is deployed through NJDOE Homeroom. Designated user(s) must have an account set up granting access to the APSSD Repository with an assigned “userid and password”, by the Homeroom Administrator.

Please submit this completed form for the 20XX-20XX school year via the APSSD Repository by October 1, 20XX or within 30 days of entering into a new related party lease or service agreement. If an APSSD enters into a related party transaction during the school year, a completed form must be filed, via APSSD Repository, within 60 days of the

Please forward this information to the appropriate personnel in the APSSD’s administrative offices, including the school business manager. If you have any questions concerning this form, please contact Elise Sadler-Williams at (609) 376-3703 or doe.pssd@doe.nj.gov.