2020-2021 Asset Information Form - Dependent
You and your parent(s) must complete, print, sign, and submit this form. Do not leave any section blank. If an item does not apply enter “0” in
the associated space. Instructions for submission are at the bottom of the form.
A. Student Information
B. Asset Information
Enter the dollar amount for the market value of each of the asset types listed below. Provide an amount for you and your parent(s). If the
market value is negative or the item does not apply enter “0” in the associated space.
Cash, Savings, and Checking Account Balances. Enter the amount as of the day your financial aid
application was originally filed. Do not enter average monthly balances or student financial aid.
Other Real Estate Market Value*, not your primary residence. Enter the total market value of all real
estate, except your primary residence. Include rental property (including a unit within a family home
that has its own entrance, kitchen, and bath rented to someone other than a family member), land,
and/or second/summer homes and vacation properties.
Investment Market Value*. Enter the total market value of all investments other than retirement
accounts. Include items such as trust funds; UGMA and UTMA accounts; money market funds; mutual
funds; certificates of deposit; stocks; stock options; bonds; other securities; Coverdell savings accounts
(education IRAs); 529 and other college savings plans, the refund value of 529 prepaid education
tuition plans for all members of the household (reported as parental investment when student is
dependent); installment and land sale contracts (including mortgages held); commodities; precious
and strategic metals; etc. Do not include the value of life insurance; retirement accounts (pensions
funds, 401k plans, annuities, non-education IRAs, Keogh plans, etc.); UGMA and UTMA accounts for
which you are a custodian, not owner; or any cash, savings, or checking accounts already reported
Business Market Value*. Only include the value of land, buildings, machinery, equipment,
inventories, etc. for a business with over 99 full-time employees. Do not include the value of your
home, even if it is part of the business.
Investment Farm Market Value*. Only include the value of the farm if it is not your principal place of
residence, and you and your family materially participated in the farming operation. Include the value
of the land, buildings, machinery, equipment, livestock, inventories, etc. (This amount is usually
indicated by a Schedule F and included on line E of the IRS Form 1040.)
*Market Value is the total value of the asset(s) minus any debts related to the asset(s) as of the day you completed your FAFSA. If the market
value is negative or the item does not apply enter “0” in the associated space.
C. Certification and Signatures
Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional information is
attached. The student and one parent MUST sign and date this section.
WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced to jail, or both.
______________________________________________________________________ _______________
Student Signature Required Date
______________________________________________________________________ _______________
Parent Signature Required (If due to the current national situation your parent cannot Date
sign the form, complete section below)
My parent is not able to sign because___________________________________________________________________________________
________________________________________________________________________________________________ __________________
Student Initials Required
WAYS TO SUBMIT THIS FORM: (1) Upload this form directly into the Student Information System (SIS) by logging into MY VWCC. Once
logged in, go to the Student Center and select the ‘VWCC 19/20 Dependent # in Coll’ from the ‘To Do List’ list to attach and upload the
form. (2) Upload the form at
www.virginiawestern.com by clicking ‘Contact Us,’ and then clicking the 24/7 Student Support icon. Once
you log in you can submit documents. (3) Fax forms to 540-857-6208
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Phone: (855)874-6690 (Revised 04_2020)
VWCC Student ID - REQUIRED
