Independent Student Early Estimate Form
Financial Aid Early Estimate Form 2016-2017 (Independent Student)
First Name: Last Name:
Address: City:
State: Zip:
Phone Number:  
HS/College GPA: ACT Score:
1. Student's Marital Status:
2. State of legal residence
3. Student's Date of Birth
4. Will you have your first Bachelor's degree before July 1, 2016?  Yes  No
5. Number of family members in your household for the period of July 1, 2016 through June 30, 2017   
(Include yourself, your parent(s) and your parent(s) other children if they get more than half their support from your parent(s)).
6. Number of family members listed in #5 attending college during 2016-2017  
(Include yourself, your spouse, and any children as long as they will attend at least half-time in 2016-2017 in a program that leads to a college degree or certificate.)
7. Where will you live: on campus off campus with parents
SECTION II: STUDENTS TAX INFORMATION (Do not leave any items blank.)
* If you are unsure about your 2015 data please answer the questions using your completed 2014 tax information - Keeping in mind your estimate could change once your 2015 Federal taxes are complete.
8.  Type of 2015 tax form you will/did file
9. Your actual or estimated 2015 Adjusted Gross Income
(2015 IRS 1040 Form-line 37; 1040A Form-line 21; or 1040EZ Form-line 4)
10. Your actual or estimated 2015 income tax paid
(2015 IRS 1040 Form-line 56; 1040A Form-line 37; or 1040EZ Form-line 10)
11. Your total actual or estimated 2015 income from work
(This information may be on your W-2 forms (Box 1 + 8) or on 2015 IRS 1040 lines 7+12+18 + Box 14 of IRS Schedule K-1 (Form 1065); 1040A line 7 or 1040EZ line 1)
12. Your total 2015 estimated Untaxed Income
(Please include: child support received, contributions to tax deferred savings plans, disability, worker's compensation, etc.)
13. Students total 2015 income exclusions
(Please include: child support paid, education credits from IRS form 1040-line 50 or 1040A-line 33, taxable earnings from the Federal Work Study Program, etc.)
SECTION III. STUDENT'S ASSET INFORMATION (Do not leave any items blank)
14. Your total current balance of cash, savings, checking accounts
15. Your value of current investments   
(Include real estate, second homes, trust funds, money market funds, certificates of deposit, stocks, bonds, securities, etc. DO NOT include the home you live in or retirement plans)
16. Debt against your current investments
(DO NOT list a mortgage against your home which is your principal residence, only debt against investments reported in question 16)
** Skip question 17 if you own a family farm, and your family resides on the farm, and you file a Schedule F on a U.S. Tax Return, or if you own a small business that has 100 or fewer full-time or full-time equivalent employees.
17. Your business and/or investment farm value   
Debt against business and/or investment farm

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