Qualified Education Benefits Assessment Form

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Qualified Education Benefits
Assessment Form
2016-2017
Student Financial Aid
Student Financial Aid has received information indicating you may be utilizing qualified education benefits or funds from
an education savings account to help meet your university fees. Qualified education benefits and education savings
accounts include prepaid tuition plans offered by states such as the Ohio Tuition Trust Authority (also known as 529
prepaid tuition plans), qualified tuition programs such as College Advantage (also known as 529 savings plans), and
Coverdell education savings accounts. The majority of college savings plans are paid directly to the school’s billing office.
Report below the refund value of the type of qualified education benefits plan or education savings account you are
utilizing. For most plans the refund value is defined by the U. S. Department of Education as the cash amount the owner of
the plan would receive if the account were cashed in as of the date the FAFSA is filed. The value of accounts held for
siblings must also be reported. Use a separate piece of paper to report sibling account information if necessary.
STUDENT’S FIRST/LAST NAME
BGSU ID
:
:
_________________________________________________________
_________________________________________
SECTION A
: Complete this section if the owner or custodian of this account is:
1. Parent listed on FAFSA (for Dependent student); or
2. Student or spouse (for Independent student)
(If owner or custodian of this account is NOT listed on your FAFSA, complete SECTION B.)
CHECK THE APPLICABLE PLAN BELOW AND REPORT THE REFUND VALUE OF THE PLAN AS OF THE DATE THE FAFSA
WAS FILED.
□ PREPAID TUITION PLANS/QUALIFIED TUITION PROGRAMS (OTTA, Ohio’s College Advantage or other
529 plans from a state other than Ohio):
Who is the owner or custodian of this account? __________________________________________________
What is the cash value of this account? $ _________________________________________________________
Was the value of this plan included in assets you reported on the FAFSA?
□Yes
□No
□ COVERDELL EDUCATION SAVINGS ACCOUNT:
Who is the owner or custodian of this account? __________________________________________________
What is the cash value of this account? $ _________________________________________________________
Was the value of this plan included in assets you reported on the FAFSA?
□Yes
□No
□ OTHER. Please describe: _______________________________________________________________________________________________
Who is the owner or custodian of this account? ___________________________________________________
What is the cash value or balance of this account? $ ____________________________________________
Was the value of this plan included in assets you reported on the FAFSA?
□Yes
□No

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