Verif Dependent Student Asset Information Worksheet

2017-2018 DEPENDENT STUDENT ASSET INFORMATION WORKSHEET

Please print this form, complete and return to the One Stop for Student Services

Student Name

Student KSU ID Number

The Student Financial Aid Office at Kent State University completed the initial review of your 2017-2018 Free Application for Federal Student Aid (FAFSA) and found incomplete information regarding student assets. Please complete and return this form to the address listed below.

THE PROCESSING OF YOUR FINANCIAL AID ELIGIBILITY WILL STOP UNTIL THIS FORM IS COMPLETED AND RETURNED

Please state the net worth of all assets as of the date you originally completed the FAFSA. Net worth equals current value of the asset minus debt owed on that asset.

What is the net worth of your current investments? Investments include real estate (do not include the home you live in), trust funds, money market funds, mutual funds, certificates of deposit, stocks, stock options, bonds, other securities, installment and land sale contracts (including mortgages held), commodities, etc. Do not include the value of life insurance policies, retirement plans, pension plans, annuities, non-educational IRA's, Keogh plans, etc. Do not include the value of tuition savings plans (529 college saving plans or pre-paid tuition plans) that are owned by the parent or the student. Education IRA's must be included.	$ _________________
What is the net worth of your business? (include land, buildings, machinery, equipment, inventory, etc.)	$ _________________
Is the business owned and controlled by the student?	Circle one: YES NO
Does the business employ less than 100 full-time employees?	Circle one: YES NO
What is the net worth of your investment farm? (don't include a farm that you live on and operate)	$ _________________
What was your total current balance of cash, savings, and checking accounts, as of the day you completed the FAFSA?	$ _________________

By signing this application you hereby affirm that all information reported on this form and any attachment hereto is true, complete, and accurate to the best of your knowledge. You understand that the Student Financial Aid Office at Kent State University will correct the FAFSA application, as necessary, based on the information submitted. You agree that you understand that if you received federal student aid based on incorrect information, you will need to repay it. You may also be required to pay fines and fees. By signing below, you certify that you (1) will use federal and/or state student financial aid only to pay the cost of attending an institution of higher education, (2) are not in default on a federal student loan or have made satisfactory arrangements to repay it, (3) do not owe money back on a federal student grant or have made satisfactory arrangements to repay it, (4) will notify your college if you default on a federal student loan and (5) will not receive a Federal Pell Grant from more than one college for the same period of time.

Student's Signature

Date

ONE STOP FOR STUDENT SERVICESS_SFA_VER_SAWD
P.O. Box 5190, Kent, OH 44242 ♦ Phone: 330-672-6000 ♦ Fax: 330-672-6001 ♦ Email: onestop@kent.edu