Instructions for Completing STAC 5’s

12. Certification of Evaluation. This field must be completed by the CPSE Chairperson. School District should retain a copy of the STAC 5 and forward the original to the municipality.

13. Municipality Signature Section. Place to record County signature or County Initials (for electronic transfers). All STAC 5’s which need to be processed by the STAC Unit (those which require special justifications from school districts) must be authorized by the Municipality Representative.

Item on back of STAC-5

Person completing this form. A name and telephone number should be provided here. This will allow the County/STAC Unit staff to resolve any problems or questions about the STAC-5 in the most timely manner.

NOTE: The School District needs to xerox a copy of the STAC 5 for their files and forward the original to the municipality.