Student Name(Required) First Last Student ID Number(Required)Check the boxes that apply:(Required) Student and spouse (if married) were not employed and had no income earned from work in 2023. Complete Section II Student and / or spouse were employed in 2023 and have listed below the names of all employers, the amount earned from each employer in 2023, and whether an IRS W-2 from is provided. [Provide copies of all 2023 IRS W-2 forms issued by your employers]. List every employer even if the employer did not issue an IRS W-2 form. Complete Section I and Section II. Section IList(Required)Employer’s NameIRS W-2 Provided?Annual Amount Earned in 2023 Add RemoveTotal Amount of Income Earned from Work(Required)Section IIStudent (spouse if married) Student (spouse if married) Average Monthly Rent / UtilitiesStudent (spouse if married) Average Monthly FoodStudent (spouse if married) Average Monthly Child CareStudent (spouse if married) Average Monthly MiscellaneousStudent (spouse if married) Average Monthly Expenses TOTALStudent (spouse if married) Resources (Check ALL that apply) Government Aid (Supplemental Nutrition Assistance Program (SNAP), Infants & Children (WIC), Supplemental Security Income (SSI), Temporary Assistance for Needy Families (TANF), Sections 8 (HUD), Military Benefits (including housing) Child support received Unemployment Worker’s compensation Income from employment Other untaxed income Money received, or aid on your behalf, not reported elsewhere Government Aid AmountChild support received amountUnemployment AmountWorker’s compensationIncome from employmentOther untaxed incomeMoney received, or aid on your behalf, not reported elsewhereTotal Student (spouse if married) Resources ReceivedIf the above information is ALL zeros or does not sufficiently explain how the household living expenses were met in 2023, you MUST provide a detail statement below that explains how your household expenses are met.Please include any excluded items (with amounts) from the above table. These amounts will not be included nor counted against your FAFSA SAI; they will help explain how the household survived on so little reported income.By signature, you certify that all of the information given is complete and correct. You understand that you may lose consideration for financial aid if you do not submit All verification documents in a timely manner.Student Signature(Required) TweetShareShare
