Financial Aid Applications Page 2
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3FINANCIAL INFORMATION (Explanatory notes can be added on page 3)
Current Tax Year 20___
Salary and wages – First Parent/Guardian
$
Salary and wages – Second Parent/Guardian
$
Dividend and/or interest income
$
Business Income
$
Unemployment Income
$
Real Estate Income
$
Pension and/or annuity Income
$
IRA distributions
$
Alimony received
$
Child support received
$
Social security and/or Disability benefits
$
Other income
$
TOTAL INCOME
$
Total Federal income taxes paid –
$
line 61, form 1040; line 28, form 1040A
Total State Income taxes paid –
$
line 39 on NYS IT-201
Total Local Income taxes paid
$
Total Property taxes paid
$
Total medical and dental expenses not covered by insurance
$
Unusual expenses (explain on page 3)
$
Annual housing expenses
Monthly rent OR
$
X 12 =
Monthly mortgage
$
X 12 =
Maintenance fees
$
X 12 =
Monthly utilities
$
X 12 =
TOTAL
Parents’/Guardians’ Assets
House, co-op or condominium (if owned):
Year purchased ____________
Purchase Price $______________________ Current outstanding mortgage $______________________
Value of other real estate owned
$____________________
Total of checking and savings accounts:
$____________________
Value of other investments (please give details on page 3)
$____________________
Parents’/Guardians’ Liabilities
Total outstanding loans (not mortgages)
$____________________
Credit card indebtedness:
$____________________
Do you own your own automobile?
Yes
No If yes, make_____________ and year_____________
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