Fillable 2020-2021 RENEWAL APPLICATION Custodial Parent(s) Complete This Form (Occidental College)

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2020-2021 RENEWAL APPLICATION Custodial Parent(s) Complete This Form (Occidental College)

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Families must submit this application, the 2020-2021 FAFSA, and the Student Online Supplement by March 2nd to be considered a priority
applicant. In addition, by March 2nd we will also require copies of student and parent 2018 tax returns and W-2(s) submitted via IDOC.
Custodial Parent(s) Complete This Form
HOUSEHOLD SIZE
Complete the following chart and list ALL members of the household that you will support between July 1, 2020 and June 30, 2021. Don't
forget to include the Oxy student and yourself, the parent(s), as part of the household.
Name
Relationship
to Student
DOB
(MM/YYYY)
2020-2021
College/Univ
Attending
2020-2021
Year in
College
2020-2021
Enrollment
Status
Degree
Seeking
EXAMPLE:
Oswald Tiger
Self 01/1999 Oxy
2nd
Full-Time BA
EXAMPLE:
O. Tiger Sr.
Father 01/1965 N/A
N/A
N/A N/A
Only answer questions that apply to your family situation. Write “N/A” if a question does not apply.
Custodial Parent(s)
Name of Custodial Parent 1: _________________________ Name of Custodial Parent 2/Step-Parent: _________________________
Primary Residence _________________________ Primary Residence _________________________
City, State, Zip _________________________ City, State, Zip _________________________
Telephone _________________________ Telephone _________________________
E-mail _________________________ E-mail _________________________
Non-Custodial Parent(s)
Name of Non-Custodial Parent: _________________________ Name of Non-Custodial Step-Parent: _________________________
Primary Residence _________________________ Primary Residence _________________________
City, State, Zip _________________________ City, State, Zip _________________________
Telephone _________________________ Telephone _________________________
E-mail _________________________ E-mail _________________________
PARENT PERSONAL INFORMATION
RENEWAL APPLICATION
2020-2021
STUDENT’S NAME:
OXY ID:
Occidental College
Financial Aid Office
1600 Campus Road F-35
Los Angeles, CA 90041
Phone: 323-259-2548
Fax: 323-341-4961
finaid@oxy.edu
www.oxy.edu/financial-aid
Image
Code: C300
CBFinAid ID:
_______________
1. Provide amounts of all untaxed income that you, the custodial parent(s), received in 2018. If you did not have income from any of these
sources, please indicate $0.
$____________ Social Security (su
ch as SSI)
$____________ Disability Benefits
$____________ Workman’s Compensation
$____________ Non-Educational VA Benefits
$____________ FSA Contributions
$____________ HSA Contributions
$____________ Living Allowance
(clergy/military)
$____________ Cash Support from Others
$____________ Welfare Benefits
$____________ SNAP (aka Food Stamps)
$____________ TANF Benefits
$____________ All Other Untaxed Benefits
2. Please list any child support you received in 2018 for all children in your household:
Child #1 Child #2 Child #3 Child #4
Name of Child __________________ __________________ __________________ __________________
Amount of Annual Support $_________________ $_________________ $_________________ $__________________
Year Support will End __________________ __________________ __________________ __________________
Person Providing Support __________________ __________________ __________________ __________________
Report all assets held in the custodial parent(s) name(s) as of today’s date. If more than one property, business, or farm is owned,
please use a separate sheet of paper to itemize each property, business, or farm.
1. List all sources of cash, savings, and investments. Please do not list retirement accounts (e.g, 401K, 403B, IRA, tax sheltered annuities).
Source (e.g. inheritance, earnings, 529 accounts, gifts)
$______________ Cash, Savings & Checking ________________________________________________
$______________ Stocks & Bonds ________________________________________________
$______________ Trust Funds ________________________________________________
$______________ Other Securities/Investments ________________________________________________
2. Do you own the home where you reside?......................................NO YES
$______________ Current Market Value
$______________ Current Debt (include 1st & 2nd mortgages)
$______________ Purchase Price
_______________ Year Purchased
_______________ Percent Ownership
3. Do you own real estate other than the home where you reside? NO YES
$______________ Current Market Value
$______________ Current Debt
$______________ Purchase Price
_______________ Year Purchased
_______________ Percent Ownership (if owned less than 100%, only list your share of the market value and debt, not the total)
4. Do you own a business?...................................................................NO YES
______________________________ Type of Business
$______________ Current Market Value
$______________ Current Debt (not owed to yourself/shareholders)
$______________ Purchase Price
_______________ Year Purchased/Opened/Inherited
_______________ Percent Ownership
_______________ Number of Employees
If you file a corporate or partnership tax return for your business, you must submit a copy of that tax return to our office.
5. Do you own a farm?..........................................................................NO YES
______________________________ Type of Farm
$______________ Current Market Value
$______________ Current Debt (not owed to yourself/shareholders)
$______________ Purchase Price
_______________ Year Purchased/Opened/Inherited
_______________ Percent Ownership
If you own a farm, do you live on the farm for more than 50% of the year? NO YES
ASSETS
UNTAXED INCOME
Address of Property:
___________________________________
___________________________________
___________________________________
Address of Property:
___________________________________
___________________________________
___________________________________
Address of Business:
___________________________________
___________________________________
___________________________________
Address of Farm:
___________________________________
___________________________________
___________________________________
Image Code: C300
CBFinAid ID: _______________
Child #1 Child #2 Child #3 Child #4
Name of Child __________________ __________________ __________________ __________________
Age of Child __________________ __________________ __________________ __________________
Amount of Tuition Paid $_________________ $_________________ $_________________ $_________________
Name of Private School __________________ __________________ __________________ __________________
Will this expense continue during the 2020-2021 academic year? NO
YES
2. List the total amount of elder care expenses you paid in 2019. Only list support provided to elder family members who do not reside in your
home.
Person #1 Person #2 Person #3 Person #4
Name __________________ __________________ __________________ __________________
Age __________________ __________________ __________________ __________________
Annual Support $_________________ $_________________ $_________________ $_________________
Will this expense continue during the 2020-2021 academic year? NO
YES
3. List the total amount of medical, dental, or vision expenses paid in the 2019 calendar year that were not covered by insurance or
otherwise reimbursed. Do not include cost for insurance premiums paid. Please provide documentation with a summary sheet for all
noted expenses. If you itemized your medical/dental expenses on Schedule A of your 2019 taxes, you may submit that schedule in lieu of
receipts.
Person #1 Person #2 Person #3 Person #4
N
ame of Family Member __________________ __________________ __________________ __________________
Amount of Medical Expenses Paid $_________________ $_________________ $_________________ $_________________
Type of Medical Expense __________________ __________________ __________________ __________________
Will this expense continue during the 2020-2021 academic year? NO
YES
4. List the total amount of educational loan payments made in 2019. This only includes higher education loans (such as a PLUS loan or if the
custodial parent(s) is in repayment of their own student loans). Please provide documentation, such as an account payment history from the
lender showing the borrower's name , dates and payment amounts.
Loan #1 Loan #2 Loan #3 Loan #4
Name of Person Holding Loan __________________ __________________ __________________ __________________
Amount of Loan Paid $_________________ $_________________ $_________________ $_________________
Type of Loan __________________ __________________ __________________ __________________
Will this expense continue during the 2020-2021 academic year? NO YES
If your family has special circumstances that impact your ability to contribute financially to your child’s education, please submit a
letter of special circumstances with any applicable documentation. Please note that if you (or the student) have previously requested a
special circumstance, and that circumstance was taken into account when determining financial aid last year, you MUST indicate that
the circumstance has continued and provide appropriate supporting documents. If no information is provided, the Financial
Aid Office will assume that no adjustment is necessary for the 2020-2021 academic year. You are responsible for knowing
financial aid policies and procedures. Please review the Financial Aid Policy Guide located online at www.oxy.edu/financial-aid/policies.
I certify that all information reported on this form and any attachments and subsequent information provided to the Occidental College
Financial Aid Office is true, complete, and accurate to the best of my knowledge. I understand that if it is determined that I purposely
provided false or misleading information in an effort to receive federal financial aid, I may be fined, sentence to jail, or both. This will also be
cause for referral (of the student) to the Judicial Council for possible violations of the Occidental College Code of Student Conduct. The
student and parent(s) may also be referred to the U.S. Department of Education Inspector General.
Parent Signature (no electronic signatures) Print Name
Date
CERTIFICATION
SPECIAL CIRCUMSTANCES
EXPENSES (THIS SECTION IS OPTIONAL)
List expenses paid in 2019, NOT 2018. Please provide documentation when requested. Expenses listed without documentation will not
be considered.
1. List the total amount of private elementary/secondary school tuition paid in 2019-2020. DO NOT list tuition for children who will be
attending college in 2020-2021. Please provide documentation to verify your payments made (i.e., tuition receipts, copies of
cashed checks, or statement from the school).
Image Code: C300 CBFinAid ID: __________________
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2020-2021 RENEWAL APPLICATION Custodial Parent(s) Complete This Form (Occidental College)

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Completed 24 August 2020

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