Buena Vista University - Dependent Student Information

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Dependent Student Information

2009-2010 Academic Year

All fields are required. Please fill out all fields before pressing submit. If there are any questions please contact the Office of Financial Assistance at finaid@bvu.edu or by phone at 800.383.2821.

1. Social Security Number:

2. Phone Number:

3. Name:
First:
Middle:
Last:

Address:

City:

State:

Zip Code:

E-mail Address:

4. Have you attended any other college or university after graduating from high school?

Yes No

If yes, what was your cumulative college GPA?
If yes, number of transfer credit hours:

5. While in college, where do you plan to live?

On campus
Off campus
With parents or relatives

6a. ACT composite score, if available:

6b. Combined SAT score, if available:

6c. Cumulative high school GPA:

6d. High school class rank:
out of

6e. Month/Year of High School Graduation:

6f. Name of High School:

7. Student's estimated 2008 taxable income:

8. Student's estimated 2008 untaxed income & benefits:
Include any tax-deferred IRA, Keogh, 401(k) and 403(b) plan payments made in 2007, including amounts reported on W-2 Forms in boxes 12a-12d; odes D, E,F,G,H and S, untaxed portions of IRA or pensions, 2007 nontaxable interest and dividends, child support, housing food and other living allowances paid to members of the military, clergy and others, workers' compensation, etc.

9. Student's savings and other assets:
(Real estate and investments: Include real estate (other than your home), trust funds, money market funds, mutual funds, certificates of deposit, stocks, bonds, other securities, installment and land sale contracts, commodities, UGMA, UTMA, JTTEN, Coverdell savings accounts, the refund value of 529 state prepaid tuition plans, and 529 plans, etc. minus any debt that is related to these assets. Do not include the value of life insurance and retirement plans (pension funds, annuities, noneducational IRAs, Keogh plans.)

10. Veterans education benefits you expect to receive from July 1, 2009 through June 30, 2010:

.00/mo. for months
Chapter Number

Parent Financial Information

11. What is your parents' current marital status?

Married
Unmarried (single, divorced, separated, or widowed)

12. Age of older parent:

13. Parents' state of legal residence:

14. Number of family members in 2009-2010:
(Enter the number of people your parents will support between July 1, 2009 and June 30, 2010. Include yourself, your parents, and other children who will get more than half of their support from your parents. If your parents support others, include them if they provide more than half of their support and that support will continue.)

15. Number of children in college in 2009-10:
(Of the children included in question 14, how many will be enrolled at least half-time in college degree or certificate programs between July 1, 2009 and June 30, 2010? If your parents are in college, do not include them.)

16. For 2007, your parents filed a:

Form 1040
Form 1040A or 1040EZ
No tax return was filed (Skip to question 20)
(If you filed an IRS Form 1040 for 2007 but will be eligible to file a 1040A or 1040EZ for 2008, or if you use a 1040 Telefile, check the box for Form 1040A or 1040EZ.)

17. 2007 total number of exemptions:
(Form 1040 or 1040A line 6d; 1040EZ filers, enter 1 if single, 2 if married.)

18. 2007 Adjusted Gross Income:
(Form 1040 line 37, 1040A line 21, or 1040EZ line 4)

19. 2007 Federal tax paid:
(Form 1040-line 57, or 1040A-line 35, or 1040EZ-line 10.)

20. 2007 income earned from work by Father/stepfather:
(Include amounts your father/stepfather earned from working in 2007. Form 1040 sum of lines 7, 12, 18, and box 14 of schedule K-1; 1040A line 7; 1040EZ line 1. Report your father's/stepfather's earnings separately from your mother's/stepmother's. If your parents did not file a tax return, add up earnings from your father's/stepfather's W-2 forms and other earnings from work not reported on W-2 forms.)

Mother/stepmother:
(Include amounts your mother/stepmother earned from working in 2007. Form 1040 sum of lines 7, 12, 18, and box 14 of schedule K-1; 1040A line 7; 1040EZ line 1. Report your mothers's/stepmother's earnings separately from your father's/stepfather's. If your parents did not file a tax return, add up earnings from your mother's/stepmother's W-2 forms and other earnings from work not reported on W-2 forms.)

21. Total 2007 untaxed income:
Include any tax-deferred IRA, Keogh, 401(k) and 403(b) plan payments made in 2007, including amounts reported on W-2 Forms in boxes 12a-12d; odes D, E,F,G,H and S, untaxed portions of IRA or pensions, 2007 nontaxable interest and dividends, child support, housing food and other living allowances paid to members of the military, clergy and others, workers' compensation, etc. received in 2007.

22. Exclusions to income:
(Child's support paid, educational credits, hope and lifetime tax credits, other grant and scholarship reported in adjusted gross income.)

23. How much will your parents' 2008 income change (+ or -) from 2007?
Increase Decrease
Your financial aid eligibility for 2009-2010 will be based on your parents' 2008 income. Write in the amount that your parents expect their income to increase or decrease between 2007 and 2008.

24. Cash, savings, and checking accounts:
(Value as of today. Do not include lump sum pension funds.)

25. Real estate and investments:
Include real estate (other than your home), trust funds, money market funds, mutual funds, certificates of deposit, stocks, bonds, other securities, installment and land sale contracts, commodities, UGMA, UTMA, JTTEN, Coverdell savings accounts, the refund value of 529 state prepaid tuition plans, and 529 plans, etc. minus any debt that is related to these assets. Do not include the value of life insurance and retirement plans (pension funds, annuities, noneducational IRAs, Keogh plans).

26. Business or farm equity:
(Today’s market value minus debt. Do not include a family farm if it is your principal residence and your parents participate in its operation. Also, do not include the value of a small business that your parents own that has 100 or fewer full-time employees.)

Please retype the above letters: Required