Fillable Asset Verification Parent (Pitzer College)

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Asset Verification Parent (Pitzer College)

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The Asset Verification Parent (Pitzer College) form is 2 pages long and contains:

  • 1 signature
  • 7 check-boxes
  • 84 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Pitzer College

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Student Name (please print)
Student ID (if known)
Asset Verification – Parent
2020-2021
Additional information is required regarding the assets you reported on the FAFSA and/or CSS Profile. Please note:
Do not leave any questions blank. If a question does not apply to you, please write $0 or N/A.
For all assets, report the amounts as of the date your student completed the FAFSA or today’s date (whichever came
first).
Do not include personal loans, consumer loans, financial aid or the value of life insurance policies.
1. Parent Information
Whose information is reported on this form? (Check all that apply)
2. Cash, Checking and Savings
Total value of cash, savings and checking: $
List banks or other institutions where you have checking or savings accounts and list the balances in those accounts.
$ $
Institution 1 Balance1 Institution 2 Balance 2
$ $
Institution 3 Balance 3 Institution 4 Balance 4
3. Home
Do you own the home where you reside? Yes No
Address of Home
$ Current Market Value
(Please list the physical address. Do NOT list P.O. Boxes.)
$ Current Debt (1
st
& 2
nd
mortgages)
$ Purchase Price
Purchase Year
Percent Ownership
Is this a multi-family home?
Yes
No
If yes, list number of dwellings:
Do you rent this property to others?
Yes
No
If yes, list date you began renting (month/year):
If yes, list what percent of your home you rent:
If you rent to family, list name(s)/relation:
4. Other Real Estate
Do you own real estate other than the home where you reside?
Yes No
Address of Property 1
$ Market Value
(Please list the physical address. Do NOT list P.O. Boxes.)
$ Debt
$ Purchase Price
Purchase Year
Percent Ownership
Address of Property 2
$ Market Value
(Please list the physical address. Do NOT list P.O. Boxes.)
$ Debt
$ Purchase Price
Purchase Year
Percent Ownership
Both Parents Custodial Parent Noncustodial Parent Step-parent
Parent 1 Name Parent 2 Name (if applicable)
Student Name (please print)
Student ID (if known)
Asset Verification – Parent
2020-2021
*If you own more than two properties, itemize each additional property on a separate sheet of paper and attach it to this form.
6. Investments
Do you own investments, such as stocks, bonds, certificates of deposit, trust funds, mutual funds, etc.?
Yes
No
If yes, list the value of all investments for all parent(s) whose information is reported on this form.
$
Do you have a retirement account, such as a 401(k), 403(b) or IRA? Yes No
If yes, list the value of all retirement accounts for all parent(s) whose information is reported on this form.
$ Parent 1 Value
$ Parent 2 Value (if applicable)
Does the student or their sibling(s) have a college savings plan (529 plan, UTMA, UGMA)? Yes No
If yes, list the value of all 529 plans owned by parent(s) and the value of all UTMAs & UGMAs for all children.
Child’s Name Value of 529 Plan Owned by Parent(s) Value of UTMAs & UGMAs
Example: Cecil Sagehen $20,000 $10,000
7. Certification
I certify that the information reported on this form and all supporting documentation is true and accurate to the best of my
knowledge. I understand that false statements or misrepresentations will be cause for denial, reduction, withdrawal and/or
repayment of financial aid.
Parent Signature Print Name Date
5. Business/Farm
Do you own a business and/or farm? (Check all that apply)
Business
Farm
Neither
If you own a farm, do you live on the farm for more than 50% of the year?
Yes
No
Address of Business/Farm 1 $ Market Value
(Please list the physical address. Do NOT list P.O. Boxes.)
$ Debt
$ Purchase Price
Year Purchased/Opened/Inherited
Percent Ownership
Number of Employees
Address of Business/Farm 2
$ Market Value
(Please list the physical address. Do NOT list P.O. Boxes.)
$ Debt
$ Purchase Price
Year Purchased/Opened/Inherited
Percent Ownership
Number of Employees
*If you own more than two businesses/farms, itemize each additional business/farm on a separate sheet of paper and attach it
to this form.
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Asset Verification Parent (Pitzer College)

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Completed 25 August 2020

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