DO NOT MAIL THIS WORKSHEET.

STATE AID DEADLINES

Check with your financial aid administrator for these
You must complete and submit a Free Application for Federal Student Aid states and territories:
(FAFSA) to apply for federal student aid and to apply for most state and AL, *AS, CO, *FM, GA, *GU, *HI, *MH, *MP, NC, NE, *NM,
*NV, OR, PR, *PW, *SD, *TX, UT, *VA, *VI, *VT, WA, WI and *WY.
college aid. Applying online with FAFSA on the Web at www.fafsa.ed.gov is
faster and easier than using a paper FAFSA.
AK April 15, 2009 (date received)
AR Academic Challenge - June 1, 2009
For state or college aid, the deadline may be as early as January 2009. Workforce Grant - Contact your financial aid
administrator
See the table to the right for state deadlines. Check with your high school Higher Education Opportunity Grant
counselor or your college's financial aid administrator about other deadlines. - June 1, 2009 (fall term)
- November 1, 2009 (spring term)
(date received)
• This Worksheet is optional and should only be completed if you plan to AZ March 1, 2009 (date received)
use FAFSA on the Web. *CA Initial awards - March 2, 2009
Additional community college awards
• Sections in purple are for parent information. - September 2, 2009 (date postmarked)
#*CT February 15, 2009 (date received)
• In parentheses after each question is the number that is used on FAFSA on *DC June 30, 2009 (date received by state)
the Web and the paper FAFSA. However, not all of the questions appear on DE April 15, 2009 (date received)
this worksheet. FL May 15, 2009 (date processed)
IA July 1, 2009 (date received)
• Submit your FAFSA early, but not before January 1, 2009. #*ID Opportunity Grant - March 1, 2009 (date received)
#IL First-time applicants - September 30, 2009
Continuing applicants - August 15, 2009 (date received)
Apply Faster—Sign your FAFSA with a Federal Student Aid PIN. IN March 10, 2009 (date received)
If you do not have a PIN, you can apply for one at www.pin.ed.gov. Your PIN #*KS April 1, 2009 (date received)
allows you to electronically sign when you submit your FAFSA. If you are #KY March 15, 2009 (date received)
providing parent information, one parent must also sign your FAFSA. To sign LA July 1, 2009 (date received)
#MA May 1, 2009 (date received)
electronically, your parent should also apply for a PIN. MD March 1, 2009 (date received)
ME May 1, 2009 (date received)
MI March 1, 2009 (date received)
You will need the following information to complete this MN 30 days after term starts (date received)
Worksheet: MO April 1, 2009 (date received)
#MS MTAG and MESG Grants - September 15, 2009
❏ Your Social Security Number and your parents’ Social Security Numbers if HELP Scholarship - March 31, 2009 (date processed)
you are providing parental information. #MT March 1, 2009 (date received)
ND March 15, 2009 (date received)
❏ Your driver’s license number if you have one. NH May 1, 2009 (date received)
❏ Your Alien Registration Number if you are not a U.S. citizen. NJ June 1, 2009, if you received a Tuition Aid Grant
in 2008 -2009
❏ 2008 federal tax information or tax returns (including IRS W-2 All other applicants
information) for yourself (and spouse if you are married) and for your - October 1, 2009, fall & spring terms
parents if you are providing parental information. If you have not yet filed a - March 1, 2010, spring term only (date received)
2008 income tax return, you can still submit your FAFSA but you must *NY May 1, 2010 (date received)
OH October 1, 2009 (date received)
provide income and tax information. #OK April 15, 2009 (date received) for best consideration
❏ Information on savings, investments, and business and farm assets for *PA All 2008 - 2009 State Grant recipients & all
non-2008 - 2009 State Grant recipients in degree
yourself and your parents if you are providing parental information. programs - May 1, 2009
All other applicants - August 1, 2009 (date received)
WARNING! NOTE: #RI March 1, 2009 (date received)
Be wary of organizations that If you or your family have unusual SC Tuition Grants - June 30, 2009 (date received)
circumstances (such as loss of #TN State Grant - March 1, 2009
charge a fee to submit your
State Lottery - September 1, 2009 (date received)
application or to find you money employment), complete FAFSA on #*WV March 1, 2009 (date received)
for college. In general, the help the Web to the extent you can, then
you pay for can be obtained for submit the application and consult
free from your college or from the financial aid office at the # For priority consideration, submit application by date specified.
Federal Student Aid. college you plan to attend. * Additional form may be required.

WWW.FAFSA.ED.GOV 2009-2010 FAFSA ON THE WEB WORKSHEET PAGE 1

 SECTION 1 – STUDENT INFORMATION
Questions are ordered as they appear on FAFSA on the Web, but after you are online you may be able to skip some questions based
on your answers to earlier questions.

Your last name (Q1)

Your Social Security Number (Q8) - -

Your driver’s license number (optional) (Q11)

Are you a U.S. citizen? (Q14) ❏ U.S. citizen (U.S. national)

If you are neither a citizen nor an eligible noncitizen, you are ❏ Eligible noncitizen Generally, you are an eligible noncitizen if you are:
not eligible for federal student aid. However, you should still • A permanent U.S. resident with a Permanent Resident Card (I-551);
complete the application, because you may be eligible for state • A conditional permanent resident (I-551C); or
or college aid. • The holder of an Arrival-Departure Record (I-94) from the Department of Homeland Security
If you are in the U.S. on an F1 or F2 student visa, or a J1 or J2 showing any of the following designations: “Refugee,” “Asylum Granted,” “Parolee” (I-94
exchange visitor visa, or a G series visa (pertaining to confirms paroled for a minimum of one year and status has not expired), “Victim of human
international organizations), you must answer “Neither citizen trafficking,” T-Visa holder (T-1, T-2, T-3, etc.) or “Cuban-Haitian Entrant.”
nor eligible noncitizen.” ❏ Neither citizen nor eligible noncitizen

Your Alien Registration Number (Q15)

A
If you are an eligible noncitizen, enter your eight- or nine-digit Alien Registration Number.

What is your marital status as of today? (Q16) ❏ Single, divorced or widowed

“As of today” refers to the day that you sign your FAFSA. ❏ Married or remarried ❏ Separated

Month and year you were married, separated, divorced or widowed (Q17) M M Y Y Y Y
(Example: Month and year: 05/1998)

What is your state of legal residence? (Q18)

Enter the date you became a legal resident of your state if it was not before
M M Y Y Y Y
January 1, 2004. (Q20) (Example: Month and year: 05/2005)

Most male students must register with Selective Service to get federal aid. If ❏ Register me
you are male, age 18-25 and NOT registered, select “Register me.” (Q22)
Have you ever received federal student aid?
❏ Yes
Answer “No” if you have never received federal student grants, federal student loans or federal work-study. You should also answer “No”
❏ No
if you have never attended college. If you answer “No” to this question, skip question 23.

Have you been convicted for the possession or sale of illegal drugs for an offense that occurred while you
were receiving federal student aid (grants, loans or work-study)? (Q23)
❏ Yes
Do not count convictions that have been removed from your record or that occurred before you turned age 18, unless you were tried as an
adult. If you answer “Yes,” you can use an interactive worksheet when completing the FAFSA online. Based on your answers to the
❏ No
worksheet questions, you can determine if the conviction affects your eligibility for federal student aid. If the conviction does affect your
eligibility for federal aid, you should still submit your application because you may qualify for state or college aid.

Highest school your father completed (Q24) ❏ Middle school/Jr. high ❏ College or beyond
Some states and colleges offer aid based on the level of schooling your parents completed. ❏ High school ❏ Other/unknown
Highest school your mother completed (Q25) ❏ Middle school/Jr. high ❏ College or beyond
Some states and colleges offer aid based on the level of schooling your parents completed. ❏ High school ❏ Other/unknown

❏ 1st bachelor’s degree ❏ Certificate or diploma (occupational,

When you begin the 2009-2010 ❏ 2nd bachelor’s degree technical or educational program of two
school year, what degree or ❏ Associate degree (occupational or technical program) or more years)
certificate will you be working ❏ Associate degree (general education or transfer program) ❏ Teaching credential (nondegree program)
on? (Q29) ❏ Certificate or diploma (occupational, technical or ❏ Graduate or professional degree
educational program of less than two years) ❏ Other/undecided

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 SECTION 1 (CONTINUED) – STUDENT INFORMATION
When you begin the 2009-2010 ❏ Full-time (at least 12 credit hours in a term or 24 clock hours per week)
school year, what do you expect ❏ 3/4-time (at least 9 credit hours in a term or 18 clock hours per week)
your enrollment status to be? (Q30) ❏ Half-time (at least 6 credit hours in a term or 12 clock hours per week)
(Enrollment definitions refer to undergraduate ❏ Less than half-time (fewer than 6 credit hours in a term or less than 12 clock hours per week)
study.) ❏ Don’t know
In addition to grants, are you ❏ Work-study (aid earned through work) ❏ Neither
interested in being considered for ❏ Student loans (which you must pay back) ❏ Don’t know
work-study or student loans? (Q31) ❏ Both work-study and student loans

SECTION 2 – STUDENT DEPENDENCY STATUS

Were you born before January 1, 1986? (Q48) ❏ Yes ❏ No
As of today, are you married? (Q49)
❏ Yes ❏ No
(Answer “Yes” if you are separated but not divorced.) “As of today” refers to the day that you sign your FAFSA.

At the beginning of the 2009-2010 school year, will you be working on a master’s or doctorate program ❏ Yes ❏ No
(such as an MA, MBA, MD, JD, PhD, EdD, graduate certificate, etc.)? (Q50)
Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training? (Q51) ❏ Yes ❏ No
Are you a veteran of the U.S. Armed Forces? (Q52)
Answer “Yes” (you are a veteran) if you (1) have engaged in active duty in the U.S. Armed Forces (Army, Navy, Air Force, Marines or Coast
Guard) or are a National Guard or Reserve enlistee who was called to active duty for other than state or training purposes, or were a cadet or ❏ Yes ❏ No
midshipman at one of the service academies, and (2) were released under a condition other than dishonorable. Also answer “Yes” if you are not
a veteran now but will be by June 30, 2010.
Answer “No” (you are not a veteran) if you (1) have never engaged in active duty in the U.S. Armed Forces, (2) are currently an ROTC student
or a cadet or midshipman at a service academy, (3) are a National Guard or Reserve enlistee activated only for state or training purposes, or (4)
were engaged in active duty in the U.S. Armed Forces but released under dishonorable conditions.
Do you have children who will receive more than half of their support from you between July 1, 2009 and ❏ Yes ❏ No
June 30, 2010? (Q53)
Do you have dependents (other than your children or spouse) who live with you and who receive more than ❏ Yes ❏ No
half of their support from you, now and through June 30, 2010? (Q54)
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? (Q55)
Answer “Yes” if you had no living parent (biological or adoptive) at any time since you turned age 13, even if you are now adopted. Answer ❏ Yes ❏ No
“Yes” if you were in foster care at any time since you turned age 13, even if you are no longer in foster care as of today. Answer “Yes” if you
were a dependent or ward of the court at any time since you turned age 13, even if you are no longer a dependent or ward of the court as of
today. Note that the financial aid administrator at your school may require you to provide proof that you were in foster care or a dependent or
ward of the court.
Use these instructions to answer questions 56-57
Answer “Yes” if you can provide a copy of a court’s decision that as of today you are an emancipated minor or are in legal guardianship.
Also answer “Yes” if you can provide a copy of a court’s decision that you were an emancipated minor or were in legal guardianship
immediately before you reached the age of being an adult in your state. The court must be located in your state of legal residence at the time the
court’s decision was issued.
Are you or were you an emancipated minor as determined by a court in your state of legal residence? (Q56) ❏ Yes ❏ No
Are you or were you in legal guardianship as determined by a court in your state of legal residence? (Q57). ❏ Yes ❏ No
Use these instructions to answer questions 58-60
Answer “Yes” if you received a determination at any time on or after July 1, 2008, that you were an unaccompanied youth who was homeless
or, for question 60, at risk of being homeless.
• “Homeless” means lacking fixed, regular and adequate housing, which includes living in shelters, motels or cars, or temporarily living with
other people because you had nowhere else to go.
• “Unaccompanied” means you are not living in the physical custody of your parent or guardian.
• “Youth” means you are 21 years of age or younger or you are still enrolled in high school as of the day you sign this application.
At any time on or after July 1, 2008, did your high school or school district homeless liaison determine that ❏ Yes ❏ No
you were an unaccompanied youth who was homeless? (Q58)
At any time on or after July 1, 2008, did the director of an emergency shelter or transitional housing
program funded by the U.S. Department of Housing and Urban Development determine that you were an ❏ Yes ❏ No
unaccompanied youth who was homeless? (Q59)
At any time on or after July 1, 2008, did the director of a runaway or homeless youth basic center or
transitional living program determine that you were an unaccompanied youth who was homeless or were ❏ Yes ❏ No
self-supporting and at risk of being homeless? (Q60)
If you answered “YES” to ANY of the previous questions, you do not have to provide parental information. Skip to Section 4 on page 6.
If you answered “NO” to ALL of the previous questions, then you must provide parental information. Complete Section 3 on the next page.

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 SECTION 3 – PARENTAL INFORMATION
If you answered “No” to all of the questions in Section 2, you must provide parental information. Refer to your parents’ IRS tax
return when necessary. Answer the questions as of the date you will complete and sign your FAFSA.
• Grandparents, foster parents and legal guardians are not considered parents on this form unless they have legally adopted you.
• If your parent is widowed or single, answer the questions about that parent. If your widowed parent is remarried, answer the questions
about that parent and your stepparent.
• If your parents are divorced or separated, answer the questions about the parent you lived with more during the past 12 months. If you
did not live with one parent more than the other, give answers about the parent who provided more financial support during the past 12
months. If this parent is remarried, answer the questions about that parent and your stepparent.
Federal law provides that, under very limited special circumstances, you may submit your FAFSA without parental information. If
you have a special circumstance and are unable to provide parental information, FAFSA on the Web will instruct you on how to
proceed. The following are examples of special circumstances.
• Your parents are incarcerated; or
• You have left home due to an abusive family environment; or
• You do not know where your parents are and are unable to contact them (and you have not been adopted).
What is your parents’ marital status as of today? (Q61) ❏ Married or remarried ❏ Divorced or separated
“As of today” refers to the day that you sign your FAFSA. ❏ Single ❏ Widowed
Month and year your parents were married, separated, divorced or widowed.
(Q62) (Example: Month and year: 05/1998) M M Y Y Y Y
What is your parents’ e-mail address? (Q71)
If you provide your parents’ e-mail address, we will let them know your FAFSA has been processed.

What is your father’s (or stepfather’s) Social Security Number? (Q63) - -

What is your father’s (or stepfather’s) last name? (Q64)

What is your father’s (or stepfather’s) date of birth? (Q66)
M M D D Y Y Y Y
(Example: Month, day and year: 05/07/1962)

What is your mother’s (or stepmother’s) Social Security Number? (Q67) - -

What is your mother’s (or stepmother’s) last name? (Q68)

What is your mother’s (or stepmother’s) date of birth? (Q70)
M M D D Y Y Y Y
(Example: Month, day and year: 05/07/1962)

What is your parents’ state of legal residence? (Q72)

Enter the date of legal residency for the parent who has lived in the state the
longest, if it was not before January 1, 2004. (Q74) M M Y Y Y Y
(Example: Month and year: 05/2005)

❏ IRS 1040 ❏ A foreign tax return

What income tax return did your parents file or will ❏ A tax return with Puerto Rico, another U.S.
they file for 2008? (Q83) ❏ IRS 1040A, 1040EZ
territory or a Freely Associated State
If your parents have filed or will file a 1040, were they eligible to file a 1040A or
1040EZ? (Q84)
❏ Yes
A person is not eligible to file a 1040A or 1040EZ if he or she makes $100,000 or more, itemizes
deductions, receives income from his or her own business or farm, is self-employed, receives alimony or is ❏ No
required to file Schedule D for capital gains. If your parents were not required to file a tax return or they ❏ Don’t know
filed a 1040 only to claim Hope or Lifetime Learning tax credits, and would have otherwise been eligible
for a 1040A or 1040EZ, answer “Yes.”

In 2007 or 2008, did you, your parents or anyone in your parents’ household
❏ Supplemental Security Income
receive benefits from any of the federal benefits programs listed? (Q77-81)
Mark all the programs that apply. ❏ Food Stamps
Select benefits received for all of your parents’ household members. Include in your parents’ household: ❏ Free or Reduced Price School Lunch
(1) your parents and yourself, even if you don’t live with your parents; (2) your parents’ other children if
(a) your parents will provide more than half of their support between July 1, 2009, and June 30, 2010, or ❏ Temporary Assistance for Needy
(b) the children could answer “No” to every question in Section 2 of this worksheet; and (3) other people Families (TANF)
only if they 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 between July 1, 2009, and June 30, 2010. TANF ❏ Special Supplemental Nutrition Program
may have a different name in your parents’ state. Call 1-800-4-FED-AID to find out the name of the state’s for Women, Infants and Children (WIC)
program.
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 SECTION 3 (CONTINUED) – PARENTAL INFORMATION
As of today, is either of your parents a dislocated worker? (Q85)
In general, a person may be considered a dislocated worker if he or she is receiving unemployment benefits due to being laid off or ❏ Yes
losing a job and is unlikely to return to a previous occupation; has been laid off or received a lay-off notice from a job; was self-
employed but is now unemployed due to economic conditions or natural disaster; or is a displaced homemaker. A displaced ❏ No
homemaker is generally a person who previously provided unpaid services to the family (e.g., a stay-at-home mom or dad), is no ❏ Don’t know
longer supported by the husband or wife, is unemployed or underemployed and is having trouble finding or upgrading employment.

What was your parents’ adjusted gross income for 2008? (Q86)
$
Adjusted gross income is on IRS form 1040—line 37; 1040A—line 21; or 1040EZ—line 4.

Questions 89 and 90 ask about earnings (wages, salaries, tips, etc.) in 2008.
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); 1040A—line 7; or 1040EZ—line 1.

How much did your father/stepfather earn from working in 2008? (Q89) $

How much did your mother/stepmother earn from working in 2008? (Q90) $

Enter the amount of your parents’ income tax for 2008. (Q87)
$
Income tax amount is on IRS Form 1040—line 56; 1040A—line 35; or 1040EZ—line 11.

Enter your parents’ exemptions for 2008. (Q88)

Exemptions are on IRS Form 1040—line 6d or 1040A—line 6d. On the 1040EZ, if a person checked either the “you” or “spouse” box
on line 5, use 1040EZ worksheet line F to determine the number of exemptions ($3,500 equals one exemption). If a person didn’t
check either box on line 5, enter 01 if he or she is single, or 02 if he or she is married.

Your parents’ number of family members in 2009-2010. (Q75)

Include in your parents’ household: (1) your parents and yourself, even if you don’t live with your parents, (2) your parents’ other
children if (a) your parents will provide more than half of their support between July 1, 2009, and June 30, 2010, or (b) the children
could answer “No” to every question in Section 2 of this worksheet, and (3) other people only if they 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 between
July 1, 2009, and June 30, 2010.

How many people in your parents’ household will be college students between July 1, 2009 and
June 30, 2010? (Q76)
Always count yourself. Do not include your parents. Include others only if they will attend, at least half-time in 2009-2010, a
program that leads to a college degree or certificate.

Your parents’ 2008 Additional Financial Information (Q94) Complete the left column of the table on page 8.

Your parents’ 2008 Untaxed Income (Q95) Complete the left column of the table on page 8.

Parent Asset Information

As of today, what is your parents’ total current balance of cash, savings and checking accounts? (Q91) $

• Investments include real estate (do not include the family home), trust funds, UGMA and UTMA accounts, money market funds, mutual funds, certificates of
deposit, stocks, stock options, bonds, other securities, Coverdell savings accounts, 529 college savings plans, the refund value of 529 prepaid tuition plans,
installment and land sale contracts (including mortgages held), commodities, etc. For more information about reporting educational savings plans call
1-800-4-FED-AID. Investment value means the current balance or market value of these investments as of today. Investment debt means only those debts that are
related to the investments.
• Do not include the value of life insurance, retirement plans (401[k] plans, pension funds, annuities, noneducation IRAs, Keogh plans, etc.) or cash, savings and
checking accounts already reported in questions 41 and 91.
• Business and/or investment farm value includes the market value of land, buildings, machinery, equipment, inventory, etc. Business and/or investment farm debt
means only those debts for which the business or investment farm was used as collateral.
As of today, what is the net worth of your parents’ investments, including real estate (not your
parents’ home)? (Q92) $
Net worth means current value minus debt.
As of today, what is the net worth of your parents’ current businesses and/or investment farms? (Q93)
Do not include the value of a family farm that your parents live on and operate.
Do not include the value of a small business if your family owns and controls more than 50 percent of the business and the business has
100 or fewer full-time or full-time equivalent employees. For small business value, your family includes (1) persons directly related to $
you, such as a parent, sister or cousin, or (2) persons who are or were related to you by marriage, such as a spouse, stepparent or sister-
in-law.
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SECTION 4 – STUDENT FINANCES
• Answer the questions as of the date you will complete and sign your FAFSA. Refer to the IRS tax return as needed.
• If you filed a foreign tax return, use the exchange rate at www.federalreserve.gov/releases/h10/update to convert monetary units
to U.S. dollars.
• If you are married as of today, report your and your spouse’s income, even if you were not married in 2008. Ignore references to
spouse if you are single, divorced, separated or widowed.
❏ IRS 1040 ❏ A tax return with Puerto Rico,
What income tax return did you file or will you file for another U.S. territory or a Freely
❏ IRS 1040A, 1040EZ
2008? (Q34) Associated State
❏ A foreign tax return

If you have filed or will file a 1040, were you eligible to file a 1040A or 1040EZ? (Q35) ❏ Yes
A person is not eligible to file a 1040A or 1040EZ if he or she makes $100,000 or more, itemizes deductions, receives income from
his or her own business or farm, is self-employed, receives alimony or is required to file Schedule D for capital gains. If you were ❏ No
not required to file a tax return or you filed a 1040 only to claim Hope or Lifetime Learning tax credits, and you would otherwise ❏ Don’t know
have been eligible for a 1040A or 1040EZ, answer “Yes.”

What was your (and your spouse’s) adjusted gross income for 2008? (Q36)
$
Adjusted gross income is on IRS Form 1040—line 37; 1040A—line 21; or 1040EZ—line 4.

Questions 39 and 40 ask about earnings (wages, salaries, tips, etc.) in 2008. 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); 1040A—line 7; or 1040EZ—line 1.
How much did you earn from working in 2008? (Q39) $

How much did your spouse earn from working in 2008? (Q40) $

❏ Montgomery GI Bill - Active Duty (Chapter 30)

What type of veterans’ education benefits will you receive? ❏ Post-9/11 GI Bill (Chapter 33)
(Q45) ❏ Montgomery GI Bill - Selected Reserve (Chapter 1606)
❏ Reserve Educational Assistance Program (Chapter 1607)
Answer this question only if you will receive these benefits between July 1, 2009
and June 30, 2010.
❏ Vocational Rehabilitation and Employment (Chapter 31)
❏ Dependents’ Educational Assistance (Chapter 35)
❏ Any other type of veterans education benefits
If you answered “YES” to ANY question in Section 2, answer the following questions.
If you answered “NO” to all the questions in Section 2, skip to page 7.
Your number of family members in 2009-2010. (Q96)
Include in your household: (1) yourself (and your spouse), (2) your children, if you will provide more than half of their support between
July 1, 2009, and June 30, 2010, and (3) other people if they now live with you, you provide more than half of their support and you will
continue to provide more than half of their support between July 1, 2009, and June 30, 2010.
How many people in your (and your spouse’s) household will be college students between July 1, 2009
and June 30, 2010? (Q97)
Always count yourself. Include others only if they will attend, at least half-time in 2009-2010, a program that leads to a college degree
or certificate.

In 2007 or 2008, did you (or your spouse) or anyone in your

❏ Supplemental Security Income
household (from question 96) receive benefits from any of the
federal benefits programs listed? (Q98-102) Mark all the ❏ Food Stamps
programs that apply. ❏ Free or Reduced Price School Lunch
Select benefits received for all of your household members. Use the instructions ❏ Temporary Assistance for Needy Families (TANF)
in question 96 to identify who is included in your household. Answering these
questions will not reduce your eligibility for student aid or these other federal ❏ Special Supplemental Nutrition Program for Women,
benefits. TANF may have a different name in your state. Call 1-800-4-FED-AID Infants and Children (WIC)
to find out the name of your state’s program.

As of today, are you (or your spouse) a dislocated worker? (Q103)

In general, a person may be considered a dislocated worker if he or she is receiving unemployment benefits due to being laid off or
❏ Yes
losing a job and is unlikely to return to a previous occupation; has been laid off or received a lay-off notice from a job; was self- ❏ No
employed but is now unemployed due to economic conditions or natural disaster; or is a displaced homemaker. A displaced homemaker
is generally a person who previously provided unpaid services to the family (e.g., a stay-at-home mom or dad), is no longer supported ❏ Don’t know
by the husband or wife, is unemployed or underemployed, and is having trouble finding or upgrading employment.

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 SECTION 4 (CONTINUED) – STUDENT FINANCES
Enter the amount of your (and your spouse’s) income tax for 2008. (Q37)
$
Income tax amount is on IRS Form 1040—line 56; 1040A—line 35; or 1040EZ—line 11.

Enter your (and your spouse’s) exemptions for 2008. (Q38)

Exemptions are on IRS Form 1040—line 6d or 1040A—line 6d. On the 1040EZ, if a person checked either the “you” or “spouse”
box on line 5, use 1040EZ worksheet line F to determine the number of exemptions ($3,500 equals one exemption). If a person didn’t
check either box on line 5, enter 01 if he or she is single, or 02 if he or she is married.

Your 2008 Additional Financial Information amount (Q46) Complete the right column of the table on page 8.

Your 2008 Untaxed Income amount (Q47) Complete the right column of the table on page 8.

Student Asset Information (See “Parent Asset Information” on page 5 for instructions on reporting assets.)

As of today, what is your (and your spouse’s) total current balance of cash, savings and checking $
accounts? (Q41) Do not include student financial aid.
As of today, what is the net worth of your (and your spouse’s) investments, including real estate
$
(not your home)? (Q42) Net worth means current value minus debt.
As of today, what is the net worth of your (and your spouse’s) current businesses and/or investment
farms? (Q43)
Do not include the value of a family farm that you (and your spouse) live on and operate.
$
Do not include the value of a small business if your family owns and controls more than 50 percent of the business and the business
has 100 or fewer full-time or full-time equivalent employees. For small business value, your family includes (1) persons directly
related to you, such as a parent, sister or cousin, or (2) persons who are or were related to you by marriage, such as a spouse,
stepparent or sister-in-law.

SECTION 5 – COLLEGES TO RECEIVE INFORMATION

• If you do not know the school code, write the college’s name. You will have a chance online to search for the school code.
• For each college, indicate the corresponding housing plan.
1st college 2nd college 3rd college 4th college 5th college
Federal School
Code
(Q104.a) (Q104.c) (Q104.e) (Q104.g) (Q104.i)

❏ on campus ❏ on campus ❏ on campus ❏ on campus ❏ on campus

Housing Plan ❏ with parent ❏ with parent ❏ with parent ❏ with parent ❏ with parent
❏ off campus ❏ off campus ❏ off campus ❏ off campus ❏ off campus
(Q104.b) (Q104.d) (Q104.f) (Q104.h) (Q104.j)

6th college 7th college 8th college 9th college 10th college
Federal School
Code
(Q104.k) (Q104.m) (Q104.o) (Q104.q) (Q104.s)

❏ on campus ❏ on campus ❏ on campus ❏ on campus ❏ on campus

Housing Plan ❏ with parent ❏ with parent ❏ with parent ❏ with parent ❏ with parent
❏ off campus ❏ off campus ❏ off campus ❏ off campus ❏ off campus
(Q104.l) (Q104.n) (Q104.p) (Q104.r) (Q104.t)

Go to www.fafsa.ed.gov and enter the information from this worksheet.

Additional help is available online, or you can call 1-800-4-FED-AID. TTY users (hearing impaired) may call 1-800-730-8913.
For more information on federal student aid, visit www.FederalStudentAid.ed.gov.
You can also talk with your college’s financial aid office about other types of student aid that may be available.
DO NOT MAIL THIS WORKSHEET.
WWW.FAFSA.ED.GOV 2009-2010 FAFSA ON THE WEB WORKSHEET PAGE 7
 Use the tables below to report annual amounts.
For the Parents’ column, enter the amount for the student’s parent(s). For the Student’s column, enter the amount for the student (and his or her spouse).

Parents’ (Q94) 2008 Additional Financial Information Student’s (Q46)

a. Education credits (Hope and Lifetime Learning tax credits) from IRS Form
$ 1040—line 50 or 1040A—line 31. $

b. Child support paid because of divorce or separation or as a result of a legal

$ requirement. $
Don’t include support for children in your (or your parents’) household, as reported in question
96 (or question 75 for your parents).

c. Taxable earnings from need-based employment programs, such as Federal

$ Work-Study and need-based employment portions of fellowships and $
assistantships.

d. Grant and scholarship aid reported to the IRS in the adjusted gross income.
$ Includes AmeriCorps benefits (awards, living allowances and interest accrual payments), as well $
as grant and scholarship portions of fellowships and assistantships.

e. Combat pay or special combat pay.

$ Only enter the amount that was taxable and included in the adjusted gross income. Do not enter $
untaxed combat pay reported on the W-2 (Box 12, Code Q).

Parents’ (Q95) 2008 Untaxed Income Student’s (Q47)

a. Payments to tax-deferred pension and savings plans (paid directly or withheld
$ from earnings), including, but not limited to, amounts reported on the W-2 $
forms in Boxes 12a through 12d, codes D, E, F, G, H and S.

b. IRA deductions and payments to self-employed SEP, SIMPLE, Keogh and

$ other qualified plans from IRS Form 1040—line 28 + line 32 or 1040A—line $
17.

c. Child support received for all children.

$ $
Don’t include foster care or adoption payments.

d. Tax exempt interest income from IRS Form 1040—line 8b or 1040A—line

$ $
8b.

e. Untaxed portions of IRA distributions from IRS Form 1040—lines (15a

$ minus 15b) or 1040A—lines (11a minus 11b). $
Exclude rollovers. If negative, enter a zero here.

f. Untaxed portions of pensions from IRS Form 1040—lines (16a minus 16b) or
$ $
1040A—lines (12a minus 12b). Exclude rollovers. If negative, enter a zero here.

g. Housing, food and other living allowances paid to members of the military,
$ $
clergy and others (including cash payments and cash value of benefits).

h. Veterans noneducation benefits such as Disability, Death Pension, or

$ Dependency & Indemnity Compensation (DIC) and/or VA Educational $
Work-Study allowances.
i. Other untaxed income not reported, such as workers’ compensation,
disability, etc.
$ Don’t include student aid, earned income credit, additional child tax credit, welfare payments, $
untaxed Social Security benefits, Supplemental Security Income, Workforce Investment Act
educational benefits, combat pay, benefits from flexible spending arrangements (e.g., cafeteria
plans), foreign income exclusion or credit for federal tax on special fuels.

j. Money received, or paid on your behalf (e.g., bills), not reported elsewhere on
XXXXXXXXXX this form. $

PAGE 8 2009-2010 FAFSA ON THE WEB WORKSHEET WWW.FAFSA.ED.GOV