Student's Name:______________________________________USF ID or SSN:_____________________________
To complete your application for financial assistance, additional information is needed. Your 2018 Federal IRS
Income Tax Transcript reported interest, dividend, or capitals gains.
The asset values reported on the Free Application for Federal Student Aid (FAFSA) need to be verified based upon
the number below. It appears that the asset values on your application may not be have been reported correctly or
have been expended. Please review the interest, dividend, and/or capital gain income reported below. Please feel
free to contact Financial Aid Services if you have any questions regarding this information.
Questions below are regarding assets owned by: student (and spouse) or parent(s)
2018 Income Tax Return reported the following: $_______________ Interest Income Earned
$________________Dividends Income Earned
$________________Capital Gain/Loss
Assets reported on the financial aid application: $________________Cash, Savings & Checking accounts
$________________Other Real Estate & Investments
Complete the steps below to re-verify the asset information:
1. Were any assets liquidated during the previous calendar year? Yes________ No_________
2. If yes, answer the following questions:
a. Type of asset liquidated:________________________________________________________________
b. Market value of the asset at the time of liquidation: $___________________________
3. Information as to where the proceeds of the asset were deposited or spent:____________________________
4. Based upon the Federal IRS Tax asset income, re-verify the value of the assets the day the financial aid application was
a. Other Real Estate Net Worth: $_______________________ (Do not include primary home value.)
b. Investments Net Worth: $_______________________
c. Cash, Savings & Checking: $_______________________
I/We certify that the information reported above is a true and correct representation of my/our assets as of the date
the application was filed.
____________________________________________ ______________________________________________
Student's Signature Date Parent’s Signature Date
Please return the completed form to:
Financial Aid Services
500 Wilcox Street Joliet, IL 60435 | finaid@stfrancis.edu
(815) 740-3403 | Toll-free: (866) 890-8331 | Fax: (815) 740-3822
click to sign
click to edit
click to sign
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome