Revised January 2021
This form is being sent to you because your 2019 income as reported on your Free Application for Federal Student Aid (FAFSA)
is exceptionally low. Please complete the chart below to document how your living expenses are paid. All students must complete
section A. If you are a dependent student and are required to provide parent information on the FAFSA, your parent must complete
section B. Both independent and dependent can use section C to provide additional information.
A. STUDENT (and Spouse if applicable) INFORMATION
Use this chart to document how you (and your spouse) pay your basic living expenses.
How is this expense paid?
Example: pay check, loans, pell grant, child support, social security/SSI, etc.
Personal – clothing, cell
phone, entertainment, etc
Student Signature ________________________________________ Date _________________________
B. PARENT INFORMATION
Use this chart to document how your parent(s) pay their basic living expenses.
How is this expense paid?
Example: pay check, loans, pell grant, child support, social security/SSI, etc.
Personal – clothing, cell
phone, entertainment, etc
Parent Signature ________________________________________ Date _________________________
C. ADDITIONAL INFORMATION
Use this space to provide additional information about how your living expenses are paid:
2021-2022
Resource Form
Office of Financial
1300 S Country Club Road – El Reno, OK 73036
405-422-6250 – Fax: 405-422-1463
click to sign
signature
click to edit
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click to sign
signature
click to edit
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