| 1. Total
number of persons in household from July 1, 2008 through
June 30, 2009 including parents, all dependent children,
and other dependents (include student). |
|
| 2.
(a) Number of household members to
be enrolled in college (at least half
time -- 6 credits per semester)
during the 2008-09 school year (include student). |
|
| (b) How many parents
are included in the number in
college? |
|
(c) Names of colleges to be attended
by other family members counted in 2 (a)
|
| 3. Parents'
expected 2007 adjusted gross income. Include
salaries, wages, dividends, interest, pensions, alimony
and
any other taxable income. |
$ |
|
(a) Amount earned by Father/Stepfather |
$ |
Father's year of birth |
|
Occupation |
|
| (b) Amount earned by Mother/Stepmother |
$ |
Mother's
year of birth |
|
Occupation |
|
| 4. What
form will parents
file?
1040A/EZ
1040
Will not file
Total number of exemptions
|
5. Parents'
2007 non-taxable income. Include social
security benefits (received by parents,
applicant
and other children under age
18), child support, welfare benefits and
any other non-taxable income or benefits.
This includes payments made in 2007 to tax-deffered pension
and savings plans(paid directly or withheld from earnings).
Do not include income you reported in #3 |
$ |
6. In 2007, did you, your parents or anyone in your household receive bnefits from any of the federal benefit programs listed? Check all that apply:
Food Stamps
Free or Reduced Price Lunch
TANF
WIC
|
7. Approximate net
value of parents' other assets
(do not include the home you live in) including: other real estate, cash and savings,
stocks, bonds, trust funds, and other securities and education savings plans(such as state-sponsored "529" plans like PA TAP Plan).
(Do not include the value of your retirement plans). |
$ |
| 8. If parents are
are farmers, net farm value (market value less
debts or mortgage). |
$
|
| 9. If parents own a business with more than 100 full time employees, net business value (market value less
debts or mortgage). |
$ |
| 10. Student's
2007 taxable and non-taxable income. |
$ |
| 11. Student's savings
and investments. |
$ |
| 12. Are you enrolled in Pennsylvania's TAP
Plan, or any other "529" Education
Savings Plan?
Yes
No |
(a)If yes, what is the current estimated value?
Plese make sure this amount was included in parents' assets (question #7). |
$
|
| (b)Who is the owner of the account (may differ from the beneficiary)?
|
| 13. Are you enrolled in SAGE Tuition Rewards
for Private Colleges?
Yes
No |
| If yes, what is the current estimated value? |
$
|
| 14. If your family owns its home: Year purchased:
Present value: $
|
(If your family rents, enter zero in all blanks.)
Amt. still owed: $
Amt. paid for home: $
|