Item 06 Attachment 4 of SBE Agenda May 2022
This page contains information entered to a STD. 399, Economic and Fiscal Impact Statement form. To obtain a scanned copy of the submitted form, contact the California State Board of Education Office at email@example.com or at 916-319-0827.
Economic and Fiscal Impact Statement
(REGULATIONS AND ORDERS)
User entries from the STD. 399 (REV. 10/2019) Form.
Department Name: CA Department of Education
Contact Person: Dan Merwin
E-mail Address: firstname.lastname@example.org
Telephone Number: 916-319-0658
Descriptive Title From Notice Register Or From 400: Physical Fitness Test
Notice File Number: Z
Economic Impact Statement
Section A. ESTIMATED PRIVATE SECTOR COST IMPACTS (Include calculations and assumptions in the rulemaking record.)
Section A.1. Check the appropriate box(es) below to indicate whether this regulation:
- Selected option is H: None of the above (Explain below)
- Option H explanation: The regulations would not impose additional private sector costs.
Fiscal Impact Statement
Section A. FISCAL EFFECT ON LOCAL GOVERNMENT (Indicate appropriate boxes 1 through 6 and attach calculations and assumptions of fiscal impact for the current year and two subsequent Fiscal Years.)
- Selected option is 4: No additional costs or savings. This regulation makes only technical, non-substantive or clarifying changes to current law regulations.
Section B. FISCAL EFFECT ON STATE GOVERNMENT (Indicate appropriate boxes 1 through 4 and attach calculations and assumptions of fiscal impact for the current year and two subsequent Fiscal Years.)
- Selected option is 4: Other. Explain. The regulations may impose minimal cost to any State agency.
Section C. FISCAL EFFECT ON FEDERAL FUNDING OF STATE PROGRAMS (Indicate appropriate boxes1 through 4 and attach calculations and assumptions of fiscal impact for the current year and two subsequent Fiscal Years.)
- Selected option is 3: No fiscal impact exists. This regulation does not affect any federally funded State agency or program.
Fiscal Officer Signature: Digitally signed by Daniel Merwin, dated December 10, 2021
The signature attests that the agency has completed the STD.399 according to the instructions in the State Administrative Manual (SAM) sections 6601-6616, and understands the impacts of the proposed rulemaking. State boards, offices, or department not under an Agency Secretary must have the form signed by the highest ranking official in the organization.
Agency Secretary: Digitally signed by Amy Tang-Paterno, dated December 10, 2021; Signed on March 2, 2022
Finance approval and signature is required when SAM sections 6601-6616 require completion of Fiscal Impact Statement in the STD. 399.