Fillable Form Mpi - Missing Parent Info (Page 3 of 3) in pdf

Step Five (Student):

Complete this step only if you (the student) answered “Yes” to any questions in Step Three.

95. How many people are in your household?

Include:

• yourself (and your spouse),

• your children, if you will provide more than half of their support between July 1, 2016 and June 30, 2017, even if they do not live with you, and

• other people if they now live with you, you provide more than half of their support and you will continue to provide more than half of their

support between July 1, 2016 and June 30, 2017.

96. How many people in your (and your spouse’s) household (from question 95) will be college students between July 1, 2016

and June 30, 2017?

Always count yourself as a college student. Do not include family members who are in U.S. military service academies.

Include others only if they will attend, at least half-time in 2016-2017, a program that leads to a college degree or certificate.

In 2014 or 2015, did you (or your spouse) or anyone in your household (from question 95) receive benefits from any of the federal programs listed?

Mark all that apply. Answering these questions will not reduce eligibility for student aid or these programs. TANF may have a different name in your state. Call

1-800-433-3243 to find out the name of the state’s program.

97. Supplemental

98. Supplemental

99. Free or

100. Temporary Assistance

101. Special Supplemental Nutrition

Security

Nutrition Assistance

Reduced

for Needy Families

Program for Wome n , Infants,

Income (SSI)

Program (SNAP)

Price Lunch

(TANF)

and Children (WIC)

102. As of today, are you (or your spouse) a dislocated worker?

See Notes page 10.

Yes

Don’t know

Step Six (Student):

Indicate which colleges you want to receive your FAFSA information.

Enter the six-digit federal school code and your housing plans for each college or school you wish to receive your FAFSA information. You can find the

school codes at or by calling 1-800-433-3243. If you cannot obtain a code, write in the complete name, address, city and state of the

college. All of the information you included on your FAFSA, with the exception of the list of colleges, will be sent to each of the colleges you listed. In addition,

all of your FAFSA information, including the list of colleges, will be sent to your state student grant agency. For federal student aid purposes, it does not

matter in what order you list your selected schools. However, the order in which you list schools may affect your eligibility for state aid. Check with your

state grant agency for more information. To find out how to have more colleges receive your FAFSA information, read What is the FAFSA? on page 2.

HOUSING PLANS

FEDERAL SCHOOL CODE

STATE

NAME OF

103. b

103. a

on campus

COLLEGE

with parent

ADDRESS

AND CITY

off campus

STATE

FEDERAL SCHOOL CODE

NAME OF

103. d

103. c

on campus

COLLEGE

with parent

ADDRESS

AND CITY

off campus

FEDERAL SCHOOL CODE

STATE

NAME OF

103. f

103. e

on campus

COLLEGE

with parent

ADDRESS

AND CITY

off campus

FEDERAL SCHOOL CODE

STATE

NAME OF

103. h

103. g

on campus

COLLEGE

with parent

ADDRESS

AND CITY

off campus

Step Seven (Student and Parent):

Read, sign and date.

If you are the student, by signing this application you certify that you (1) will use federal and/or state

104. Date this form was completed

student financial aid only to pay the cost of attending an institution of higher education, (2) are not

MONTH

DAY

in default on a federal student loan or have made satisfactory arrangements to repay it, (3) do not

owe money back on a federal student grant or have made satisfactory arrangements to repay it, (4)

M M D D

2016

2017

will notify your college if you default on a federal student loan and (5) will not receive a Federal Pell

Grant from more than one college for the same period of time.

If you are the parent or the student, by signing this application you certify that all of the information

105. Student (Sign below)

you provided is true and complete to the best of your knowledge and you agree, if asked, to

provide information that will verify the accuracy of your completed form. This information may

include U.S. or state income tax forms that you filed or are required to file. Also, you certify that you

understand that the Secretary of Education has the authority to verify information reported on

this application with the Internal Revenue Service and other federal agencies. If you sign any

document related to the federal student aid programs electronically using a personal identification

Parent (A parent from Step Four sign below.)

number (PIN), username and password, and/or any other credential, you certify that you are the

person identified by that PIN, username and password, and/or other credential, and have not

disclosed that PIN, username and password, and/or other credential to anyone else. If you purposely

give false or misleading information, you may be fined up to $20,000, sent to prison, or both.

106.

If you or your family paid a fee for someone to

Preparer’s Social Security Number (or 107)

COLLEGE USE ONLY

FEDERAL SCHOOL CODE

fill out this form or to advise you on how to fill it

–

Homeless

out, that person must complete this part.

D/O

Youth

Determination

Preparer’s name, firm and address

107.

Employer ID number (or 106)

FAA Signature

–

108.

Preparer’s signature and date

DATA ENTRY

USE ONLY:

Page 8

For Help — 1-800-433-3243

Form Mpi - Missing Parent Info Page 3

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