County College of Morris Financial Aid Office
214 Center Grove Road finaid@ccm.edu
Randolph, NJ 07869 Fax: 973-328-5237
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Please complete the information below about your: Parent/s (If Dependent) Yourself (If Independent)
CURRENT FAFSA FILING YEAR
ANNUAL EXPENSES AND RESOURCES FORM
S
TUDENT NAME_________________________________________ CCM ID# ___________________
You must complete all sections of this form. The reason you are required to complete this form is because no income was reported on your
FAFSA or the income reported did not appear to provide sufficient financial support.
SECTION A: Report the ACTUAL amount for each expense paid by you, your parents or by someone else on your or your parents’ behalf.
YOUR ANNUAL EXPENSES
AMOUNT YOU PAID
US DOLLARS $
1.
Resident- Rental/Home mortgage expenses (do not include investment property) $
2.
Resident- Utilities (gas, electric, heating, etc.)
$
3.
Food and Household supplies $
4.
Car payments, insurance, gas and/or other transportation $
5.
Medical expenses paid out-of-pocket $
6.
Child care/Daycare (out of pocket cost only)
$
7.
Clothing $
8.
Miscellaneous (Example- Car repair):________________________________________ $
TOTAL ANNUAL EXPENSES
$
SECTION B: ANNUAL RESOURCES
Please list all the Annual resources that you used to meet the expenses listed in Section A. Be sure to include all your wages, AFDC, child
support, unemployment benefits, social security benefits, SSI and/ or any cash received. YOU MUST ATTACH DOCUMENTATION TO
SUPPORT ALL ENTRIES. Examples of acceptable documentation are prior year IRS Federal Income Tax Return Transcripts, W 2 forms,
1099 forms, and statements from agency and or persons providing the resources.
SECTION C: EXPLANATION
If, the total resources reported in Section B do not meet the total expenses reported in Section A, please use the space below to explain how the
expenses in Section A was met including support outside the country/foreign. (If you need more space, please use the reverse side of this form).
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
CERTIFICATION
I certify that all the information on this form is true, correct and complete to the best of my knowledge. I further understand that if I purposely
give fraudulent or misleading information, I will be subject to disciplinary action.
__________________________________________________________________________
Student and/or Parent Signature (if dependent) Date Rev: 5/13/2020
YOUR RESOURCES (In-kind support received if paid on your behalf, list name & relationship)
YOUR ANNUAL AMOUNT
Example- Freelance/ Cash paying job and or Foreign support in U.S. dollars
$ 1,000.00
1.
$
2.
$
3.
$
4.
$
TOTAL ANNUAL RESOURCES:
$
First Last
Print Student and/or Parent (if dependent) Sign
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