For Office Use Only: Checklist Item CommKey 9EOPIF 9ECIN FINANCIAL AID AND SCHOLARSHIP SERVICES FINANCIAL INFORMATION INQUIRY FORM 2019-2020 FOR THE EDUCATIONAL OPPORTUNITY PROGRAM (EOP) YOU MUST HAVE A 2019-2020 FAFSA ON FILE FOR US TO REVIEW YOUR APPLICATION. Student Name: Stony Brook ID: Social Security #: FAFSA filed For 2019/2020: Date filed: Included Stony Brook s School Code (002838): Based on my FAFSA results, I am: Dependent Independent 1. CITIZENSHIP/RESIDENCY: The citizenship of eligible non-citizens will be confirmed through the Department of Homeland Security. If we need any additional documentation pertaining to your citizenship or New York State residency, we will create a To Do List item which you can view on your SOLAR homepage. Be sure to respond to any requests for additional information immediately as it will hold up the review process. *I ve checked my FAFSA comments and my citizenship has been confirmed: ARE YOU A NY STATE RESIDENT? ARE YOUR PARENTS NY STATE RESIDENTS? *For Eligible noncitizens NOTE: U.S. citizenship is not a requirement for admission to EOP. However, you must meet New York State residency, income and academic requirements. If admitted, you will receive all academic and social support the program offers. However, you are not eligible to receive any financial support from the program. 1
2. PARENT S CURRENT MARITAL STATUS (For Dependent Students): (Who s My Parent When I Fill Out My FAFSA?): Married or Remarried Separated or Divorced Widowed Never Married Legal Parents not married but live together Please enter the applicable DATE for current marital status: (date married/date separated/date divorced/date widowed) in the format MM/YY. Month/Year (ex. 05/88) 3. INFORMATION ONLY ABOUT THE PARENT(S) YOU LIVE WITH: Parent 1 Parent 2 or Step-Parent Last Name, First Name: Age: College Education (DO NOT LEAVE BLANK!): Has completed a: Bachelor s Degree? Has completed a: Bachelor s Degree? Master s Degree? Master s Degree? Occupation: Name of Employer: Number of Years: Business name if Self-Employed: Unemployed since (date): Legal parents information must be provided if they are married or live together regardless of gender. If parent is remarried, step-parent s information is required on this form. 2
4. FAMILY MEMBERS INFORMATION: Give information for all family members who reside in your household. Dependent students: be sure to include yourself, your parent(s), step-parent, and any other people who may have received more than one half of their support from your parent(s). Independent students: list yourself and your spouse, as well as anyone who receives more than one half of their support from you. * FULL NAME OF FAMILY MEMBER RELATIONSHIP TO STUDENT Self AGE NAME OF COLLEGE/UNIVERSITY (If attending a college at least half time in 2019-2020) (Attach another page if needed). *If your parents do not claim these household members as dependents on their Federal tax return, official documentation confirming that they reside in the household must be provided. Examples of official documentation include school records, medical records, or utility bills and must be in household member s name. If members of your household include siblings who are attending college at least half time in the 2018-19 school year, you must include the name of the college/university they attend. Parents attending college are excluded. 5. DO YOUR PARENTS OWN A HOME? If : Year Purchased: Monthly Mortgage Payment: $ Purchase Price: $ Current Value: $ Mortgage Balance: $ 6. DO YOUR PARENTS OWN A MULTI-FAMILY HOME? Multi-family home is defined as one in which there is at least one separate apartment. Tenants reside in these apartments and pay rent to the owner of the home. For example, your parents own their home and live in a 3
section of that home, but they also rent out a section of that same home to a tenant (including any family members). 7. SOURCES OF ANNUAL INCOME 2017 (1/1/2017 12/31/2017) A) Did the parent(s) file a 2017 tax return? (If yes, submit the parent/step-parent(s) complete, signed Federal Income Tax Returns for 2017 including all schedules and W2s) Did the student file their own 2017 tax return? (If yes, submit the student s complete, signed Federal Income Tax Returns for 2017 including all schedules and W2s) Did the parent(s) and/or student receive non-taxable income and benefits in 2017? (If yes, submit documentation of non-taxable income and benefits for 2017) (Examples: Public assistance, unemployment benefits, etc.) Please complete all items. If the item does not apply to you answer with N/A. Do not leave any item blank! Parent 1/Step-parent s earnings from employment $ Parent 2/Step-parent s earnings from employment $ Student s earnings from employment $ Unemployment Benefits total $ Social Security Benefits total $ Public Assistance total $ Other Income: $ Pensions $ Capital gains $ Disability $ Annuities $ Rent received $ Alimony $ Veterans Benefits $ Workers Compensation $ Child Support received $ Money received, or paid on your behalf (e/g bills) not reported elsewhere on this form $ (Report Yearly Total) Define Source: Housing, food, and other living allowances paid to members of the military, clergy, and others, including cash payments and cash value of benefits Do not include the value of on-base military housing or the value of a basic military allowance for housing $ 4
B) BUSINESS OR SELF EMPLOYMENT INCOME FOR 2017 Business name if self employed (Report Yearly Total) Type of business or self-employment Business Income $ Business Value $ Business Debt $ C) CURRENT FAMILY ASSET INFORMATION Complete all items. If the item does not apply to you, answer with N/A Do not leave any item blank! SOURCE PARENT(S)/STEP-PARENT(S) STUDENT Value of Cash, Savings and $ $ Checking Accounts Real Estate Value $ $ Real Estate Debt $ $ Investment Value $ $ Investment Debt $ $ 8. BOTH STUDENT AND AT LEAST ONE PARENT (IF DEPENDENT) MUST SIGN BELOW. The information provided in this form is accurate and correct. Student s Signature Date Parent Signature Date Print and sign this form before submitting, electronic signature is not acceptable For secure and faster processing, submit the form by clicking on "Upload Document" located in your SOLAR To Do List te: Only '.tif' and/or '.pdf' file types are allowed for uploading. To view our video on the upload process, click here. PURPOSELY GIVING FALSE OR MISLEADING INFORMATION MAY LEAD TO DISMISSAL FROM THE PROGRAM AND THE REPAYMENT OF ANY FUNDS RECEIVED. 5