Fillable 2020 Tax Untax (University of California, Santa Cruz)

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2020 Tax Untax (University of California, Santa Cruz)

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FINANCIAL AID AND SCHOLARSHIP OFFICE
uc santa cruz
2019-20 Verification of Taxed and Untaxed Income and Assets
You have been selected by the UC Santa Cruz Financial Aid and Scholarship Oce for a process called “verication”.
In this process, we will compare information you provided on the nancial aid application with information you provide
in this packet. If necessary, we will make corrections and update your application. If you submit documents after
the due date, you may be ineligible for institutional aid programs.
Due Date: June 2, 2019 postmark (July 1 for Transfers)
Submit the completed and
signed forms to:
UC Santa Cruz
Financial Aid and Scholarship Oce
205 Hahn Student Services Building
1156 High Street
Santa Cruz, CA 95064
Page 1 of 5
YOU MUST COMPLETE ALL PAGES OF THIS PACKET
F0UNTX
If you send documents, please mail copies and do not send originals. If you have questions about the information
contained in this packet, please contact us at 831-459-2963.
Please be advised that due to FERPA laws, our oce will only speak with third parties (including parents) if
authorized on the “Authorization to Release Information” form provided directly to UCSC students.
TAX INFORMATION
Use the checklist below before mailing your information to avoid delays:
Attached copies of my parent/s and student’s 2017 tax transcript —as well as copies of all 2017 W-2 and/or 1099
forms. To obtain a copy of your tax transcript and W-2s from the IRS website, go to irs.gov/Individuals/
Get-Transcript.
My parent/s is/are not a tax filer and I have attached an IRS Verification of Non-Filing. (To obtain a copy of your
tax transcript from the IRS website, go to irs.gov/Individuals/Get-Transcript, use form 4506-T, or call 1(800)
908-9946.)
Signatures
Signatures are required on the certication found on the last page of this packet.
Answer All Questions. DO NOT LEAVE BLANKS. If something does not apply to you, respond using “N/A”
(not applicable) or a “0” (zero). A blank answer will mean the information is incomplete and you will be asked
to complete a new packet which may delay your eligibility for nancial aid.
UCSC Student’s ID /Account
Number (Do not use CRUZ ID)
UCSC Student’s Last Name
First Name
Page 2 of 5 YOU MUST COMPLETE ALL PAGES OF THIS PACKET F0UNTX
1. Print the student’s name and ID/account number clearly at the top of all pages of this packet and all documents attached.
2. The parent and student who provided the financial aid application information must complete and sign the Certification on page 5.
3. The parent and student must answer all questions. IF THE ANSWER IS ZERO, OR IS NOT APPLICABLE, WRITE IN A “O”.
Student living arrangements during the 2019-20 academic year (check one):
On Campus O Campus With parent(s)
STUDENT Please report income earned. Submit copies of all W-2s and 1099s $____________
Also, list below the names of all employers, the amount earned and whether an IRS W-2 form was provided.
I am not required to file a 2017 Federal Tax Return.
I filed a 2017 Federal Tax Return; a copy of the 2017 tax transcript is attached and all W-2s and 1099s
I filed a 2017 Foreign Tax Return, a signed copy of the foreign return plus a certified translated in English copy is
attached, converted to US Dollars.
FEDERAL TAX RETURNS AND INCOME INFORMATION
Employer’s Name Amount Earned
Was IRS form provided?
(Answer Yes or No)
Employer’s Name Amount Earned
Was IRS form provided?
(Answer Yes or No)
PARENT Please report income earned. Submit all W-2s and 1099s $____________
Also, list below the names of all employers, the amount earned and whether an IRS W-2 form was provided.
I am not required to file a 2017 Federal Tax Return and a copy of the IRS Verification of Non-Filing is attached.
I filed a 2017 Federal tax Return. A copy of the 2017 tax transcript and all W-2s and 1099s is attached.
I filed a 2017
Foreign Tax Return. A signed copy of the foreign return plus a certified translation in English, converted
to U.S. Dollars, is attached.
Do you own and control more than 50% of a business with over 100 employees? yes no
In 2017or 2018, did you or anyone in your household receive benefits from any of the Federal programs listed? Mark all programs that apply:
Supplemental Security Income Supplemental Nutrition Assistance Program (SNAP) Free or reduced price lunch TANF WIC
DO NOT LEAVE BLANKS.
1
UCSC Student’s ID /Account
Number (Do not use CRUZ ID)
UCSC Student’s Last Name
First Name
Page 3 of 5 YOU MUST COMPLETE ALL PAGES OF THIS PACKET
F0UNTX
For Oce Use Only
Real Estate Net Worth = Total of Net Value of Each Property listed above _________________
Total Investments ___________________ + Real Estate Net Worth _______________ =Total Investment Net Worth _________________________
PARENTS REAL ESTATE INVESTMENTS (not included in net worth listed above)
STUDENT REAL ESTATE INVESTMENTS
Does the student own any real estate investment property yes no
$____________________ $____________________
F OR THIS SECTION PLEASE REPORT INFORMATION AS OF THE DATE YOU FIRST FILED THE 201920 FINANCIAL AID APPLICATION.
$____________________ $____________________
PARENT STUDENT
PARENT STUDENT
Net Worth of Your Investments
Note: Investments do not include the home you live in, the value of life insurance, retirement plans (pension funds, annuities,
non-education IRA’s, Keogh plans, etc.)
Net worth of your investments, other than investment real estate reported below. Investments include trust funds, UGMA/UTMA accounts,
money market funds, mutual funds, certicates of deposit, stocks, stock options, bonds, other securities, installment and land sale contracts
(including mortgages held), commodities, etc. Investments also include qualied educational benets or education savings accounts (e.g.
Coverdell savings accounts, 529 college savings plans and the total refund value of all 529 prepaid tuition plans.
Cash, Savings and Checking Accounts
Complete this information for all real estate you (and your spouse) own such as mobile homes, condos, duplexes, rental property,
land, summer homes, etc., as of the date the 2019-20 financial aid application was filed. Do not include the home you live in.
Do you the parent(s) own real estate investments excluding the home you live in? Yes No If yes, provide details below.
Property 1 (Do not report the home you live in):
Current Market Value* $ ____________ Mortgage Balance $ ____________ Purchase Price $ ____________ Year Acquired _______
Property Address _______________________________________________________________________________________________
Street address City State Zip Code
Property 2 (Do not report the home you live in):
Current Market Value* $ ____________ Mortgage Balance $ ____________ Purchase Price $ ____________ Year Acquired _______
Property Address _______________________________________________________________________________________________
Street address City State Zip Code
Property 3 (Do not report the home you live in):
Current Market Value* $ ____________ Mortgage Balance $ ____________ Purchase Price $ ____________ Year Acquired _______
Property Address _______________________________________________________________________________________________
Street address
City State Zip Code
Complete this section if you, the parent, RENTED OUT A PORTION OF THE HOME YOU LIVE IN that meets the following criteria: the rental unit
has its own entry and includes a kitchen and bath. The portion of your home that generates rental income is considered an asset and must be
reported as an investment net worth on the nancial aid application. Complete the following information about the home you live in:
Current Market Value* $ ___________ Mortgage Balance $ ___________ Purchase Price $ ___________ Year Acquired ______
Rental Square Footage ___________ + Home Square Footage ___________ = Total Dwelling Square Footage ___________
*on the date you led the nancial aid application
UCSC Student’s ID /Account
Number (Do not use CRUZ ID)
UCSC Student’s Last Name
First Name
Page 4 of 5 YOU MUST COMPLETE ALL PAGES OF THIS PACKET F0UNTX
1. Child support received by you (and your spouse) for any of your children. Do not include
foster care or adoption payments. $_____________/yr. $_____________/yr.
2. Housing, food, and other living allowances paid to members of the military, clergy
and others (including cash payments and cash value of benets —for example, Resident
Assistant (RA) housing benets). Don’t include the value of on-base military housing or
the value of a basic military allowance for housing. $_____________/yr. $_____________/yr.
3. Veterans noneducation benets, such as Disability, Death Pension, or Dependency &
Indemnity Compensation (DIC) and/or VA Educational Work-Study allowances. $_____________/yr. $_____________/yr.
4. Other untaxed income not reported, such as workers’ compensation, disability
benets, etc. Also include the untaxed portions of health savings accounts from IRS Form
1040—line 25. Don’t include extended foster care benets, student aid, earned income
credit, additional child tax credit, welfare payments, untaxed Social Security Benets,
Supplemental Security Income, Workforce Innovation and Opportunity Act educational
benets, on-base military housing or a military housing allowance, combat pay, benets
from exible spending arrangements (e.g. cafeteria plans), foreign income exclusion, or
credit for federal tax on special fuels.
List source: _________________________________________________________________ $_____________/yr. $_____________/yr.
5. Money received as gifts or to make payments on your behalf (e.g. bills) not reported
elsewhere on this form. Do not include nancial aid. Include money received from a
parent or other person whose nancial information is not reported on this form and is
not part of a legal child support agreement.
Please state source: _______________________________ $_____________/yr. $_____________/yr.
6. Child support paid by you because of divorce or separation or as a result of a legal
requirement. Do not include support for children in your household. $_____________/yr. $_____________/yr.
7. Taxable earnings from need-based employment programs, such as Federal Work-Study
and need-based employment portions of fellowships and assistantships. $_____________/yr. $_____________/yr.
8. Combat pay or special combat pay. Only enter the amount that was taxable and
included in your adjusted gross income. Do not enter untaxed combat pay. $_____________/yr. $_____________/yr.
9. Earnings from work under a cooperative education program oered by a college. $_____________/yr. $_____________/yr.
FOR THE FOLLOWING OTHER INCOME INFORMATION, PLEASE REPORT 2017 CALENDAR YEAR INFORMATION
PARENT STUDENT
Name of person who paid child support
Name of person to whom child support
was paid
Name of child for whom support
was paid
Amount of child support paid in 2016
N/A
N/A
DO NOT LEAVE BLANKS.
Name of person who paid child support
Name of person to whom child support
was paid
Name of child for whom support
was paid
Amount of child support paid in 2016
N/A
UCSC Student’s ID /Account
Number (Do not use CRUZ ID)
UCSC Student’s Last Name
First Name
RETURN TO: UC Santa Cruz Financial Aid and Scholarship Oce, 205 Hahn Student Services Building, 1156 High Street, Santa Cruz, CA 95064
Phone: (831) 459-2963 Web: nancialaid.ucsc.edu.
PAGE 5 OF 5 YOU MUST COMPLETE ALL PAGES OF THIS PACKET
F0UNTX
CERTIFICATION
• Iherebydeclarethatallinformationreportedonthisdocumentistrue,complete,andaccuratetothebestofmy knowledge.
• Iunderstandthatanyfalsestatementormisrepresentationwillbecausefordenial,reduction,cancellationand/or repayment of financial
aid.
• ThisdocumentmustbepostmarkednolaterthanJune2,2019tomeettheprioritydeadlineforalltypesoffinancialaid.
Parent Signature ___________________________________ Date ___/____/_____ Parent Name________________________________
Parent Phone ( _______ ) ___________________________ Parent E-mail Address _____________________________________________
Student Signature ______________________________________________________ Date ____/_____/______
Student E-mail ________________________________________________
PLEASE PRINT
PLEASE PRINT
HOUSEHOLD INFORMATION
P
arent, list the people in your household. Include yourself, your spouse, and your children, if (a) you provide more than half of their support or (b) the children
would be required to provide parental information when applying for federal student aid. If you are not married but live together with the student’s other
biological/adoptive parent or as determined by the state (i.e. the parent is listed on the birth certicate), regardless of gender, list this person as Parent 2.
List any other people if they now live with you and you provide more than half of their support and will continue to provide more than half of their
support from July 1, 2019 through June 30, 2020. If you have additional people to list, attach a separate sheet of paper with the required
information. Do not include your parent(s) in college. Do not include siblings who are in U.S. Military Service Academies.
In 2016 or 2017, did you receive federal low-income housing such as HUD or Section 8? Yes No
Parent 1
Parent 2
UCSC
Student
Other
Members in
Household
Age
Full Name of Family Member
in Household
Relationship
to Student
Name of Title IV* College
(if attending in 2019–20
20)
For those enrolled at least half time in a
Title IV* college for 2019–20, select the
level of degree.
UCSC
self
* Title IV: Public or private institutions of higher education located in the U.S. or its territories.
Undergraduate Graduate student
Undergraduate Graduate student
Undergraduate Graduate student
Undergraduate Graduate student
Undergraduate Graduate student
Parent, please report your marital status as of the date you submitted the 2019-2020 financial aid application.
As of the date I filed the 2019–20 financial aid application, I, the parent, am (check one box below):
Never Married
Divorced or Separated
Married/Remarried
Widowed
Unmarried and both parents living together
month Year
month and year you were either divorced, separated,
married/reamarried or widowed
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2020 Tax Untax (University of California, Santa Cruz)

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Completed 21 July 2020

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