Financial Information Form - Binghamton
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1
2Educational Opportunity Program (EOP)
FINANCIAL INFORMATION FORM
This form is required for all fall 2016 freshmen applicants upon request. Please follow instructions on the form and answer ALL
questions. Submit all required documents to Binghamton as soon as possible. The deadline is February 1, 2016.
Completing this form is only one step in the application process. In addition to providing this information, you will also need to
submit the following items:
• 2014 Eligibility Documentation tax return, non-filer form, etc.)
• 2016-17 FAFSA (available after January 1, 2016)
It is important you check your status online
(status.binghamton.edu)
and follow up with any additional documents that may be
requested. You can view and complete additional documents through the EOP Materials Form on your status page. A decision
on your application will not be made until all materials have been received.
Questions about the EOP review process can be directed to eopadmit@binghamton.edu.
Applicant Information
First name ________________________________ Middle initial __________ Last name ________________________________________
Reference number _________________________ Date of birth ___________________ E-mail address____________________________
Name of guidance counselor ____________________________________Guidance counselor’s e-mail_____________________________
Are you a ward of the court, currently under the care of a foster agency, or do you have a legal guardian, as appointed by New York
state?
Yes
No
Are you a citizen or permanent resident of the United States?
Yes
No
Family Members and Tax Information
Complete the information below for all persons residing in your house in 2015. Additional persons should be listed on a separate page.
Will you be claimed on your parents 2015 Federal
Your name
Relationship to you
Employment status for 2015
income taxes?
Self
Yes or No (circle appropriate answer)
______________________
______________________
______________________
Will you be claimed on your parents 2015 Federal
Name of parent(s)
Relationship to you
Employment status for 2015
income taxes?
living with you
(circle appropriate)
Yes or No
______________________
Mother/Step-mother
______________________
Yes or No
______________________
Father/Step-father
______________________
Will you be claimed as a dependent on your
Names of all other
Relationship to you
Employment status of each
parent/parents’ 2015 Federal Tax Return?
individuals living in
for 2015
your house
Yes or No
______________________
______________________
______________________
Yes or No
______________________
______________________
______________________
Yes or No
______________________
______________________
______________________
Yes or No
______________________
______________________
______________________
(over)
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