2020–2021 Asset Inform
ation Form - Dependent
There are issues with your financial aid application that must be resolved in order for the Financial Aid Office to continue
processing your request for federal student aid. You and your parent(s) must complete and submit this form if you chose not
to update your federal financial aid application with asset data.
Do not leave any section blank. If an item does not apply enter “0” in the associated space. The form must be submitted to
the Financial Aid Office to continue the review process and determine your eligibility for federal student aid.
A. Student Information
__________________________________________________ ________________
Student’s Name (Last, First, M.I.) Student ID - REQUIRED
B. Asset Information
Enter the dollar amount for the market value of each of the asset types listed below. Market value is the assets’ total value
minus any debts against it as of the day you completed your financial aid application. Provide an amount for you and your
parent(s). If the market value is negative or the item does not apply enter “0” in the associated space.
Asset Type
Student’s Market Value
Parent(s)’s Market Value
Cash, Savings, and Checking Account
Balances. Enter the amount as of the
day your financial aid application was
originally filed. Do not enter average
monthly balances or student financial
aid.
$
$
Other Real Estate Market Value*, not
your primary residence. Enter the
total market value of all real estate,
except your primary residence. Include
rental property (including a unit within
a family home that has its own
entrance, kitchen, and bath rented to
someone other than a family member),
land, and/or second/summer homes
and vacation properties.
$
$
Investment Market Value*. Enter the
total market value of all investments
other than retirement accounts.
Include items such as trust funds;
UGMA and UTMA accounts; money
market funds; mutual funds;
certificates of deposit; stocks; stock
options; bonds; other securities;
Coverdell savings accounts (education
IRAs); 529 and other college savings
plans, the refund value of 529 prepaid
education tuition plans for all members
of the household (reported as parental
investment when student is
dependent); installment and land sale
contracts (including mortgages held);
commodities; precious and strategic
metals; etc. Do not include the value
of life insurance; retirement accounts
$
$
(pensions funds, 401k plans, annuities,
non-education IRAs, Keogh plans, etc.);
UGMA and UTMA accounts for which
you are a custodian, not owner; or any
cash, savings, or checking accounts
already reported above.
Business Market Value*. Only include
the value of land, buildings, machinery,
equipment, inventories, etc. for a
business with over 99 full-time
employees. Do not include the value
of your home, even if it is part of the
business.
$
$
Investment Farm Market Value*. Only
include the value of the farm if it is not
your principal place of residence, and
you and your family materially
participated in the farming operation.
Include the value of the land, buildings,
machinery, equipment, livestock,
inventories, etc. (This amount is
usually indicated by a Schedule F and
included on line E of the IRS Form
1040.)
$ $
*Market Value is the assets’ total value minus any debts related to the asset as of the day you completed your financial aid
application. If debts are greater than value indicate “0”.
C. Certification and Signatures
Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional
information is attached. The student and one parent MUST sign and date this section.
WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced to jail,
or
both.
______________________________________________________________________
_______________
Student’s Signature
D
ate
______________________________________________________________________ _______________
Parent Signature D
ate
click to sign
signature
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signature
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