OFFICE OF FINANCIAL AID
AND SCHOLARSHIPS
Check your myClackamas account for all financial aid correspondence and your Award Letter.
Secure submission of documents can be completed in person, by mail, or fax to:
Office of Financial Aid and Scholarships · Roger Rook Hall · 19600 Molalla Avenue, Oregon City, OR 97045
Phone: 503-594-6082 · Fax: 503-722-5864 · e-mail: finaid@clackamas.edu · www.clackamas.edu
Need assistance? Financial Aid Resource Lab hours: Monday-Thursday, 10am-1pm and 1:30-3
02/28/20dp
FAC20AIW
2020-2021 ASSET INFORMATION WORKSHEET
(Summer Term 2020 – Spring Term 2021)
Student Last Name Student First Name
Student ID# Date of Birth
Uponreviewofyourverificationdocuments,orduetoaFAFSArejection,weneedtoconfirmthevalueofyourassets.Please
followtheguidanceprovidedbelowtoassistyouinprovidingthisinformation.PleasecompleteALLinformationbelowasit
wasonthedateyoufirstfiledthe2020‐2021FAFSA.
Refertoyouandyourparents’/spouse’s2018federaltaxreturn.Ifafederaltaxreturnform1040wasfiled,checkfor
dollaramountslistedonlines2a,2b,3bandSchedule1lines12,13,17,or18.Ifthereisanamountonanyoftheselines,
itisanindicationofpotentialassetstobereportedontheFAFSA.Pleaselistthedollaramountofanyassetsassociated
withtheabovelinenumbersasofthedatetheFAFSAwascompleted.
NOTE:Thedollaramountlistedonthe1040isNOTthesameasassetnetworthyoulistbelow.Networthmeanscurrent
valueminusdebt.Ifyouhavenoamountspleasewritezero(0)intheboxesprovidedbelow,leavingnoblanks.
A. AssetValues(donotleaveanyblanks)
PARENT(S) OR
SPOUSE
STUDENT
1.
Totalbalanceofcash,checking,andsavingsaccounts:
$
$
2.
NetworthofInvestments(Examples:realestate,trust
funds,moneymarketfunds,mutual
funds,stocks,bonds,collegesavingsplans,etc.Donot
includeyourprimaryresidence,retirementaccounts,or
lifeinsurance
)
:
$
$
3.
NetworthofInvestmentFarm(Donotincludeifyouor
yourparent(s)liveonit):
$
$
4.
Doyouownabusiness?(CircleYES/NO).If“NO,”skip
tosectionB:
YES/NO
YES/NO
5.
If“Yes”inbox(4),doesyourbusinessemploymore
than100full‐timeemployees?(CircleYES/NO).
If“NO,”skiptosectionB:
YES/NO
YES/NO
6.
NetworthofBusiness:
$
$
B. CertificationStatement&Signatures
Bysigningbelow,IacknowledgethatIhavereadandunderstandtheinformationonthisform,andcertifythatall
informationsubmittedisaccurateandtruetothebestofmyknowledge.
_____________________________________________ _____________________
Student’sSignatureDate
__________________________________________________________________________
Parent’sSignature(RequiredifDependentStudent)Date
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