Expense/resource Form Page 2
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2FIDN#: A______________
PARENTS 2014 ANNUAL EXPENSES AND INCOME
Expenses
Parents
Income
Parents
Rent
Earnings from all jobs (Tax &
$
Untaxed)
$
Mortgage
Unemployment compensation
$
$
Food
Withdrawals from savings
$
$
Car payment/Insurance
Social Security/Disability Benefits
$
$
Car maintenance/Gas
Welfare, AFDC, TANF, SNAP
$
$
Utilities/Telephone/Cable
Child Support Received
$
$
Credit Card Payments
Alimony/Palimony Received
$
$
Child Support/Alimony Paid
Expenses billed to you & paid by
List child(ren) and age below
$
others (total dollar value)
$
Clothing
Cash received from family and/or
$
friends
$
Entertainment
Financial Aid refunds received in
$
2014
$
Child Care
*Support provided by others
$
(Please explain below)
$
Unreimbursed Medical
Tribal Benefits received in 2014
$
(total dollar value)
$
Other: Explain below
Other: Explain below
$
$
Other: Explain below
Other: Explain below
$
$
(C) Total 2014 Expense
$
(D) Total 2014 Income
$
*Examples of support include food, shelter, clothing, non-cash gifts etc. Be sure to list the total dollar value of support received in 2014.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
As certified by the signatures below, all the information provided by myself and/or others is true and complete to the best of my
(our) knowledge. I understand that the Financial Aid Office may request additional documentation to verify the above information.
Note: If you are a dependent student, you and a parent must sign this form.
Student: ___________________________________________________________
Date:________________
Spouse: ___________________________________________________________
Date:________________
Parent: ____________________________________________________________
Date:________________
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