2
In-Person locations: Service EMU 240 McKenny Hall | 268 Student Center
Email: financial_aid@emich.edu | Fax: (734) 487-4281
Mailing Address: 403 Pierce Hall, Ypsilanti, MI 48197
*Do not leave blank. Indicate zero or Not Applicable (N/A) if appropriate.*
D.
Student Federal Tax Information
Check t
he box that applies below. Be sure to complete and submit any additional requirements indicated with a
☐
Student (and spouse, if married) filed a 2016 Federal Tax Return, Puerto Rican, or Foreign Income Tax Return.
☐
Student (and spouse, if married) was employed and had income, but did not file and was not required to file a 2016
Federal IRS Tax Return.
List all employers and amount that was earned in 2016 in the chart below.
Submit copies of ALL student (and spouse) 2016 W-2 statements.
Name of Employer
Amount Earned in 2016
2016 W-2 Form received from
employer?
$
Yes
No
$
Yes
No
$
Yes
No
☐
Student (and spouse, if married) was not employed, did not
have income and was not required to file a 2016 Federal
IRS Tax Return.
E.
Asset Information
Student’s Si
gnature Date
As of the date you filed the 2018-2019 FAFSA, what is your total current balance of cash, savings and checking accounts?
Do not include student financial aid.
$ __________________
2.
As of the date you filed the 2018-2019 FAFSA, what is the net worth of your investments, including real estate? Net worth
means current value minus
debt.
Investments include: real estate (do not include the home in which you live), rental property, trust
funds, UGMA/UTMA accounts, money market funds, mutual funds, certificates of deposit, stocks, stock options, bonds, other
securities, Coverdell savings accounts, 529 college savings plans. Do not include the value of life insurance; retirement plans (pension
funds, annuities, non-educational IRAs, Keogh plans, etc).
$ __________________
3.
As of the date you filed the 2018-2019 FAFSA, what is the net worth of your current businesses and/or investment
farms?
Business or farm value includes the current market value of land, buildings, machinery, equipment, inventory, etc. Do
not include the net worth of a family owned and controlled small business with no more than 100 full-time or full-time
equivalent employees.
$ __________________
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to jail, or both.
Student ID E ___________________
Signing below certifies that all of the information reported is
complete and correct. The student must sign and date.
You must also submit a Verification of Non-Filing Letter from the IRS. (Please see page 3 for instructions on
ordering a Non-Filing Letter)
You must also submit a Verification of Non-Filing Letter from the IRS. (Please see page 3 for instructions on
ordering a Non-Filing Letter)