Step One:

All fields are required on the form. Put N/A if a category does not pertain to you (the student).

Your full name (exactly as it appears on your Social Security Card)

1. Last name

2. First name

3. Middle initial

Your permanent mailing address

4. Number and street (include apt. number)

5. City (and country if not in U.S.)

6. State

7. ZIP code

8. Your date of birth 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

9. Your permanent telephone number

10. Your cell phone number

11. Your e-mail address.

12. Are you a U.S. citizen? Yes, I am a U.S. Citizen (U.S. national). No

13. What is your marital status as of today? I am single, divorced or widowed I am married/remarried I am separated

14. What is you state of legal residence?

15. When did you become a legal resident of this state? 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

16. Are you male or female? Male Female

17. When you begin college, what will your high school completion status be? High school diploma General Education Development (GED) certificate Home schooled None of the above

18. When you begin the school year, what will be your grade level? Never attended college and 1st year undergraduate Attended college before and 1st year undergraduate 2nd year undergraduate/sophomore 3rd year undergraduate/junior 4th year undergraduate/senior 5th year/other undergraduate 1st year graduate/professional Continuing graduate/professional or beyond

19. When you begin the school year, what degree or certificate will you be working on? 1st bachelor's degree 2nd bachelor's degree Associate degree (occupational or technical program) Associate degree (general education or transfer program) Certificate or diploma (occupational, technical or education program of less than two years) Certificate or diploma (occupational, technical or education program of two or more years) Teaching credential (nondegree program) Graduate or professional degree Other/undecided

20. In addition to grants, are you interested in being considered for work-study or student loans? Work-study (student aid that you earn through work) Student loans (which you must pay back) Both work-study and student loans Neither Don't know

Continue to step 2

Step Two

Answer questions 21-27 about yourself (the student). If you are single, separated, divorced or widowed, answer only about yourself. If you are married as of today, include information about your spouse (husband or wife).

21. Have you (the student) completed your IRS income tax return or another tax return listed in question 21 I have already completed my return. I will file, but I have not yet completed my return. I'm not going to file (Skip to question 29)

22. What income tax return did you file or will you file? IRS 1040 IRS 1040A or 1040EZ

For questions 23-27, if the answer is zero or the question does not apply to you, enter 0. Report whole dollar amounts with no cents.

23. What was your (and spouse's) adjusted gross income? Adjusted gross income is on IRS Form 1040—line 37; 1040A—line 21; or 1040EZ—line 4.

24. Enter your (and your spouse's) income tax. Income tax amount is on IRS Form 1040—line 56; 1040A—line 35; or 1040EZ—line 11.

25. Enter your (and your spouse's) exemptions. Exemptions are on IRS Form 1040—6d; or Form 1040A—line6d. For Form 1040EZ.

Questions 26 and 27 ask about earnings (wages, salaries, tips, etc.). Answer the questions whether or not a tax return was filed. This information may be on the W-2 forms, or on IRS Form 1040—lines 7 + 12 + 18 + Box 14 of IRS Schedule K-1 (Form 1065); or 1040A—line 7; or 1040EX—line 1.

26. How much did you earn from working last year?

27. How much did your spouse earn from working last year?

Continue to step 3

Step Three

Answer each question in this step to determine if you will need to provide parental information.

28. At any time since you turned age 13, were both your parents deceased, were you in foster care or were you a dependent or ward of the court? Yes No

29. Are you or were you an emancipated minor as determined by a court in your state of legal residence? Yes No

30. Are you or were you in legal guardianship as determined by a court in your state of legal residence? Yes No

If you (the student) answered “No” to each question in Step 3, go to Step 4.

If you answered “Yes” to any question in Step 3, skip Step 4 and go to Step 5.

Step Four

Complete this step if you (the student) answered "No" to all questions in Step Three.

Answer all the questions in Step Four about your parents even if you do not live with them. Grandparents, foster parents, legal guardians, aunts and uncles are not considered parents on this form unless they have legally adopted you. If your parents are living and married to each other, answer the questions about them.

31. What is your parents’ marital status as of today? Married or remarried Single Divorced or separated Widowed

32. Have your parents completed their IRS income tax return or another tax return? My parents have already completed their return. My parents will file, but they have not yet completed their return. My parents are not going to file.

33. What was your parents' adjusted gross income? Adjusted gross income is on IRS Form 1040—line 37; 1040A—line 21; or 1040EZ—line 4.

Answer the questions whether or not a tax return was filed. This information may be on the W-2 forms, or on IRS Form 1040—lines 7 + 12 + 18 + Box 14 of IRS Schedule K-1 (Form 1065); or 1040A—line 7; or 1040EX—line 1.

34. How much did your father/stepfather earn from working?

35. How much did your mother/stepmother earn from working?

Continue to Step 5.

Step Five

36. How many people are in your parents’ household?
Include:

• yourself, even if you don't live with your parents,
• your parents,
• your parents' other children
• other people if they now live with your parents, your parents provide more than half of their support and your parents will continue to provide more than half of their support.

37. How many people in your parents’ household will be college students?
Always count yourself as a college student. You may include others only if they will attend, at least half-time, a program that leads to a college degree or certificate.

Upon submitting this form, a pdf document will be generated with your submitted values which should be downloaded. Further instructions will be included on the cover page of the pdf.