Fafsa Worksheets A, B And C - Untaxable Income printable pdf download

Delaware State University

Office of Financial Aid

Untaxable Income)

(

Worksheet A

Student

Ind. Student/ Parent

Earned income credit from IRS Form 1040 line 66a; 1040A-line 40a; 1040EZ-line 8a

$______________

Additional child tax credit for IRS Form 1040-line 68 or 1040A-line 41

$______________

Welfare benefits, inc luding Temporary Assistance for Needy Families (TANF) Do not

$______________

inc lude Food stamps or subsidized hous ing.

Social Security benefits received, for all household members as reported in question 90 (or

$______________

66 for your parents), that were not taxed (such as SSI).

Total

$______________

Worksheet B

Payments to tax

deferred pensions and saving plans (paid directly or withheld from

$______________

earnings), including but not limited to, amounts reported on W

2 Form in Box 12a through

12d, codes D, E, F, G, H, and S.

IRA deductions and payment of self-

employed SEP, SIMPLE, and Keogh and other

$______________

qualified plans from IRS Form 1040

tota l of lines 28+32 or 1040A line 17.

Child support received for all children. Do not include foster care or adoption payments.

$______________

Tax exempt interest income from IRS Form 1040-line 8b or 1040A-line 8b.

$______________

Foreign income exclus ion from IRS Form 2555-line 45 or 2555EZ

line 18.

$______________

Untaxed portions of IRA distribution from IRS Form 1040-lines (15a minus 15b) or 1040A

$______________

lines (11a minus 11b). Exclude rollovers. If negative, enter a zero here.

Untaxed portions of pensions from IRS Form 1040 lines (16a minus 16b) or 1040A

lines

$______________

(12a minus 12

b). Exclude rollovers. If negative, enter zero here.

Credit for federal tax on special fuels from IRS Form 4136

line

-20-

nonfarmers only.

$______________

Housing food, and other living a llowances paid to members of the military, clergy, and

$______________

others (including cash payments and cash value benefits.)

Veterans’ non

education benefits, such as Death Pension or Dependency.

$______________

Any other untaxed income

and benefits not reported elsewhere on Worksheets A and B,

$______________

such as worker’s compensation, untaxed portions of railroad retirement benefits, Black Lung

Benefits, disability, etc,

Money received, or paid on your behalf (e.g

. bills) not reported elsewhere on this form.

$______________

Total

$______________

Worksheet C

Education credits (Hope and Lifetime Learning Tax Credits) from IRS 1040-

line 50, or

$______________

1040A

-line 31

Child support paid because of divorce or separation or as a result of a legal requirement. Do

$______________

not include support for children in your (or your parents’) household, as reported in question

90 (or question 66 for your parents)

Taxable earnings from need

based employment programs, such as Federal Work

-Study and

$______________

need based employment portions of fellowships and assistantship.

Student grant and scholarship aid reported to the IRS in your (or your parents’) adjusted

$______________

gross income. Includes AmeriCorps benefits (awards, living allowances, and interest accrual

payments), as well as grant or scholarship portion

s of fellowships and assistantships.

Total

$______________

Sign This Worksheet:

____________________________________________________

________________________________________________

Student Signature

Date

Parent/Spouse Signature

Date

Fafsa Worksheets A, B And C - Untaxable Income

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