Outline
The Indiana State Form 51804, known as the Career College Student Assurance Fund Quarterly Collection (CCSAF-1), plays a crucial role in the financial operations of postsecondary proprietary institutions in Indiana. This form is essential for reporting and calculating the quarterly contributions these institutions must make to the Career College Student Assurance Fund, which is designed to protect students from financial loss due to certain unforeseen circumstances. Each institution must submit a separate form for each campus location, ensuring that all relevant information is accurately reported. The form requires detailed reporting on tuition earned from both Indiana residents and out-of-state students, as well as any refunds issued during the quarter. Institutions must also calculate their required contributions based on net tuition earned, alongside an additional fee. Timeliness is key, as payments are due within 45 days following the close of each quarterly reporting period. Failure to comply can lead to serious consequences, including the potential loss of accreditation. With clear instructions and a structured layout, Form 51804 is designed to facilitate compliance while safeguarding the interests of students enrolled in proprietary education programs across the state.
Form Sample
CAREER COLLEGE STUDENT ASSURANCE FUND |
FOR OFFICE USE ONLY |
QUARTERLY COLLECTION |
Date stamp upon receipt (month, day, year) |
State Form 51804 (R2 / |
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Approved by State Board of Accounts, 2011 |
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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
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)
SECTION A - REPORTING INFORMATION
1. |
COPE advertising code |
2. Reporting quarter (check appropriate box) |
July 1 - September 30 |
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3. Year of reporting quarter |
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January 1 - March 31 |
April 1 - June 30 |
October 1 - December 31 |
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4. |
Name of contact person (person responsible for completing this form) |
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5. Daytime telephone number |
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SECTION B - OWNER INFORMATION |
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Name of owner (legal, partnership, corporate, or other entity name) |
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If sole owner (last name, first name, middle initial, suffix) |
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3. |
Primary address (number and street, city, state, and ZIP code) |
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4. |
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SECTION C - CAMPUS INFORMATION |
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Business trade name / DBA |
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2. |
Physical address (number and street, city, state, and ZIP code - no PO Box numbers) |
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3. Telephone number of business location |
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4. Fax number of business location |
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SECTION D - REPORT OF QUARTERLY EARNED TUITION |
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1. Total Gross Tuition / Instructional fees received from all Indiana residents this quarter: |
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2. Total Gross Tuition / Instructional fees received from all out of state residents instructed within Indiana this quarter: |
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3. Total value of refunds made this quarter (to students from, or instructed in, Indiana): |
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4. Net tuition earned (Lines D1 + D2 - D3): |
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SECTION E - CALCULATION OF REQUIRED CONTRIBUTION |
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1. Required FUND Contribution (0.1% Net Tuition; Line D4 X .001): |
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2. Additional Required Fee (IC |
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$60.00 |
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3. Total Payment this quarter (Lines E1 + E2): |
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SECTION F - SIGNATURE AND CERTIFICATION OF NOTARY PUBLIC |
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STATE OF _______________________________ |
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SS: |
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COUNTY OF _____________________________ |
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I, ________________________________________________________________, first being duly sworn on oath say that I am the above named, |
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that I have personally prepared the foregoing application, and that the same is true to the best of my knowledge and belief. |
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Signature of person completing this form |
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Date subscribed and sworn (month, day, year) |
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Printed or typed name of person completing this form |
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Signature of notary public |
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Printed or typed name of notary public |
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County of residence |
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Date commission expires (month, day, year) |
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INSTRUCTIONS FOR COMPLETING STATE FORM 51804, CAREER COLLEGE STUDENT ASSURANCE FUND QUARTERLY COLLECTION
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
State Form 51804 is used to calculate and process quarterly payments to the Career College Student Assurance Fund as directed under IC
This form and the required payment must be submitted quarterly in accordance with IC
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
Payment of the Additional Required Fee (Line E2) is required every quarter as defined in IC
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
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)
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
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
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
570 IAC
Sec. 3. (a) The proper amount of a postsecondary educational institution’s fund contribution shall be calculated in accordance with IC
(b)Upon receipt of a contribution from a school to the fund, the check shall be deposited into the fund within
(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
Sec. 4. Each postsecondary proprietary institution shall make quarterly contributions to the fund in compliance with IC
570 IAC
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.
Form Specifics
| Fact Name | Fact Description |
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| Form Purpose | The Indiana State Form 51804 is used to calculate and process quarterly payments to the Career College Student Assurance Fund. |
| Governing Laws | This form is governed by IC 21-17-3-9 and 570 IAC, which outline the requirements for contributions to the fund. |
| Submission Deadline | Payments and completed forms are due 45 days after the end of each quarterly reporting period. |
| Quarterly Reporting | The reporting quarters are January 1 - March 31, April 1 - June 30, July 1 - September 30, and October 1 - December 31. |
| Separate Forms | A separate form is required for each campus location that needs to report and contribute to the fund. |
| Contact Information | For questions, contact the Indiana Commission on Proprietary Education at (317) 232-1320. |
| Tuition Reporting | Section D of the form requires reporting gross tuition and instructional fees from both Indiana residents and out-of-state residents. |
| Required Contribution | The required contribution to the fund is 0.1% of net tuition earned, plus an additional $60 fee. |
| Notary Requirement | The form must be signed and certified by a notary public to ensure authenticity and compliance. |
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