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
02/28/20dp
FAC20AIW
2020-2021 ASSET INFORMATION WORKSHEET
(Summer Term 2020 – Spring Term 2021)
Student Last Name Student First Name
Student ID# Date of Birth
Uponreviewofyourverificationdocuments,orduetoaFAFSArejection,weneedtoconfirmthevalueofyourassets.Please
followtheguidanceprovidedbelowtoassistyouinprovidingthisinformation.PleasecompleteALLinformationbelowasit
wasonthedateyoufirstfiledthe2020‐2021FAFSA.
Refertoyouandyourparents’/spouse’s2018federaltaxreturn.Ifafederaltaxreturnform1040wasfiled,checkfor
dollaramountslistedonlines2a,2b,3bandSchedule1lines12,13,17,or18.Ifthereisanamountonanyoftheselines,
itisanindicationofpotentialassetstobereportedontheFAFSA.Pleaselistthedollaramountofanyassetsassociated
withtheabovelinenumbersasofthedatetheFAFSAwascompleted.
NOTE:Thedollaramountlistedonthe1040isNOTthesameasassetnetworthyoulistbelow.Networthmeanscurrent
valueminusdebt.Ifyouhavenoamountspleasewritezero(0)intheboxesprovidedbelow,leavingnoblanks.
A. AssetValues(donotleaveanyblanks)
PARENT(S) OR
SPOUSE
STUDENT
1.
Totalbalanceofcash,checking,andsavingsaccounts:
$
$
2.
NetworthofInvestments(Examples:realestate,trust
funds,moneymarketfunds,mutual
funds,stocks,bonds,collegesavingsplans,etc.Donot
includeyourprimaryresidence,retirementaccounts,or
lifeinsurance
:
$
$
3.
NetworthofInvestmentFarm(Donotincludeifyouor
yourparent(s)liveonit):
$
$
4.
Doyouownabusiness?(CircleYES/NO).If“NO,”skip
tosectionB:
YES/NO
YES/NO
5.
If“Yes”inbox(4),doesyourbusinessemploymore
than100full‐timeemployees?(CircleYES/NO).
If“NO,”skiptosectionB:
YES/NO
YES/NO
6.
NetworthofBusiness:
$
$
B. CertificationStatement&Signatures
Bysigningbelow,IacknowledgethatIhavereadandunderstandtheinformationonthisform,andcertifythatall
informationsubmittedisaccurateandtruetothebestofmyknowledge.
_____________________________________________ _____________________
Student’sSignatureDate
__________________________________________________________________________
Parent’sSignature(RequiredifDependentStudent)Date