Clarification of Income and Expenses

Student Name*

First Name

Last Name

Student ID #*

Upon reviewing the Financial Aid Application for the 2024-2025 academic year, the reported income information for your parents (please list their names below) requires further explanation.

Parent Name (1)*

First Name

Last Name

Parent (1) Email Address*

Parent Name (2)

First Name

Last Name

Parent (2) Email Address

Please list the following yearly income amounts received or paid for by others in 2022 for parents(s).

Employment (Including copies of W-2s)

SNAP (Supplemental Nutrition Assistance Program (Food Stamps))

Child Support

Social Security

General Relief

Section 8 Housing Supplement

Support Received from Other Persons

Name of Person/Group and Relationship

Value of Bills Paid by Other Persons

Name of Person/Group and Relationship

Workers Compensation

VA Benefits

Pension

Any other Income

Income Total

Please list the following yearly expenses for 2022

Room/Rent/Mortgage

Board (Food)

Utilities

Telephone

Clothing

Insurance (Health, Life, Auto, Tenant)

Medical Expenses

Transportation

Household Maintenance

Recreation

Household Maintenance

Miscellaneaous

Expense Total

Parent (1) Signature*

[clear]

Use your mouse or finger to draw your signature above

Parent (2) Signature

[clear]

Use your mouse or finger to draw your signature above