2021-2022 Asset Request Form
Revised 11/23/2020
Student’s Name: _____________________________________ Student ID# ___________________
For the 2021-2022 Verification, student [and parent(s), if student is dependent] need to complete and
submit the “2021-2022 Asset Request Form,” indicating the value of all assets as of the date the student
completed the 2021-2022 FAFSA. Asset information was left blank on the FAFSA but is required
because the student does not qualify for simplified needs analysis.
This form must be completed in full in order for our office to complete the verification process for 2021-
2022. If you do not have any dollar amount to report please use zero “0.” Blank or incomplete forms will
not be processed.
• DEPENDENT student: Please refer to the “Verification Request for Additional
Information” letter that was emailed to you to determine if asset information is required for
student, parent(s), or both.
• INDEPENDENT students who are married must include their spouse’s assets in the student
section.
STUDENT PARENT(S)
As of the date the 2021-2022 FAFSA was completed, what was your
total balance for cash, savings, and checking accounts?
$ $
As of the date the 2021-2022 FAFSA was completed, what was the
net worth of your investments, including real estate? Net worth
means value minus debt. DO NOT include the home you live in.
$ $
As of the date the 2021-2022 FAFSA was completed, what was the
net worth of your business and/or investment farms? DO NOT
include a family farm or family business with 100 or fewer full-time
or full-time equivalent employers.
$ $
By signing this worksheet, I certify that all of the information reported is completed and correct to the
best of my knowledge. I further understand that purposely giving false or misleading information may
result in a fine, jail terms, or both.
Student Signature: _____________________________________ Date: ______________________
*Parent Signature: _____________________________________ Date: ______________________
* Parental information/signature are only required if student is DEPENDENT.
SUBMISSION INSTRUCTIONS:
• Print and complete the “2021-2022” Asset Request Form”
• Submit singed form to the Student’s Financial Aid Office
