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Financial Aid Early Estimate Form 2013-2014 (Dependent Student)
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone Number:
HS/College GPA:
ACT Score:

SECTION I.  STUDENT'S PERSONAL INFORMATION AND STATUS  (Do not leave any items blank.)
1.   State of legal residence
2.   Student's Date of Birth
3.   Will you have your first Bachelor's degree before July 1, 2013?  YES  NO
4.   Number of family members in your parent(s) household for the period of July 1, 2013 through June 30, 2014    (Include yourself, your parent(s) and your parent(s) other children if they get more than half their support from your parent(s)).
5.   Number of family members listed in #4 attending college during 2013-2014    (Include yourself and siblings, as long as they will attend at least half-time in 2013-2014 in a program that leads to a college degree or certificate) (Do not include your parent(s))
6.   Age of older parent
7.   Parent(s) Marital Status: Married Single Separated
8.   Where will you live: on campus off campus with parent(s)

SECTION II.  PARENT(S) TAX INFORMATION (Do not leave any items blank.)
9.    Type of 2012 tax form your parent(s) will/did file 1040 1040A 1040EZ Did not file
10.  Parent(s) actual or estimated 2012 Adjusted Gross Income (2012 IRS 1040 Form-line 37; 1040A Form-line 21; or 1040EZ Form-line 4)
11.  Actual or Estimated 2012 US Income Tax paid (2012 IRS 1040 Form-line 55; 1040A Form-lines 35; or 1040EZ Form-line 10).
12.  Father's actual or estimated total 2012 income from work    Mother's actual or estimated total 2012 income from work (This information may be on their W-2 forms (Box 1 + 8) or on 2012 IRS Form 1040 lines 7+12+18 + Box 14 of IRS Schedule K-1 (Form 1065); 1040A line 7 or 1040EZ line 1)
13.  Parent(s) total 2012 estimated Untaxed income   (Please include: child support received, contributions to tax deferred savings plans, disability, worker's compensation, etc.)
14.  Parents total 2012 income exclusions   (Please include: child support paid, education credits from 2012 IRS form 1040-line 49 or 1040A-line 31, taxable earnings from the Federal Work Study program, etc.)
 
SECTION III. PARENT(S) ASSET INFORMATION (Do not leave any items blank - if it is $0, please answer $0.)
15.  Parent(s) total current balance of cash, savings, checking accounts
16.  Parent(s) 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.)
17.  Debt against parent(s) 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 18 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.
 
18.  Parent(s) current business and/or investment farm value    Current debt against business and/or investment farm
 
SECTION IV: STUDENT'S TAX INFORMATION (Do not leave any items blank.)
19.  Type of 2012 tax form you will/did file 1040 1040A 1040EZ Did not file
20.  Your actual or estimated 2012 Adjusted Gross Income (2012 IRS 1040 Form-line 37; 1040A Form-line 21; or 1040EZ Form-line 4)
21.  Your actual or estimated 2012 income tax paid (2012 IRS 1040 Form-line 55; 1040A Form-lines 35; or 1040EZ Form-line 10)
22.  Your total actual or estimated 2012 income from work (This information may be on your W-2 forms (Box 1 + 8) or on 2012 IRS 1040 lines 7+12+18 + Box 14 of IRS Schedule K-1 (Form 1065); 1040A line 7 or 1040EZ line 1)
23.  Your total 2012 estimated Untaxed Income (Please include: child support received, contributions to tax deferred savings plans, disability, worker's compensation, etc.)
24.  Students total 2012 income exclusions (Please include: child support paid, education credits from 2012 IRS form 1040-line 49 or 1040A-line 31, taxable earning from the Federal Work Study Program, etc.)
 
SECTION V: STUDENT'S ASSET INFORMATION (Do not leave any items blank - if it is $0 please answer $0.)
26.  Your total current balance of cash, savings, checking accounts
27.  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.)
28.  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 27)

** Skip question 29 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.
 
29.  Your business and/or investment farm value Debt against business and/or investment farm

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