Independent Student Civil Union Worksheet
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Independent Student Civil Union Worksheet 2016-2017
A: Student’s Information
_______________________________________
_____
_____________________________________
1. Student’s name
First
M.I.
Last
2. Student’s
permanent
______________________________________________________________________________________________________________________
mailing address
Number, street and apartment number
(do not give
college address)
________________________________________
______
_______________
City
State
Zip Code
3. Student’s Social Security Number (SSN)
________ -- _____ -- __________
Is this a change in SS#?
Yes
No
(If “Yes”, attach a copy of the SS# card.)
4. Date of Civil Union:
MM /
YY
B: Student’s Civil Union Partner
________________________________
_________________________________
5. Student’s Civil Union Partner’s name
Last
First
5A. Student’s Civil Union Partner’s Social Security Number (SSN) ________ -- _____ -- __________
)
C: Household Information
6. How many people are in
your household? Include:
7. Number of college students in 2016-2017
• yourself,
Enter the number of family members
• your partner,
included in item 6 who will be in college at
• your children and your partner’s children if you will
least half time. Include yourself – the student
provide more than half of their support between
who is applying for aid.
July 1, 2016 and June 30, 2017
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