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FAC19PJY (Howard Community College)

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Country of origin: US
File type: PDF

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A. Student’s Information
Student’s Last Name Student’s First Name Student’s M.I. Student’s HCC ID Number
B. Family Information
Number of Household Members: List below the people in your household. Include:
Yourself.
Your spouse, if married
Your or your spouse’s children, if you or your spouse will provide more than half of the children’s support from July 1, 2019 through
June 30, 2020, even if a child does not live with you. Do not include children for whom child support is paid or foster children
supported by another entity.
Other people if they now live with you and you or your spouse provide more than half of the other person’s support, and will con-
tinue to provide more than half of that person’s support through June 30, 2020.
Full name Date of Birth Marital status as of today
Student:
Single Married/Remarried on
Mont h/ Year
Separated on
Mont h/ Year
Divorced/Widowed on
Mont h/ Year
Spouse:
Is spouse enrolled in college at least half time? Yes No College:
Full name of dependent children
Relationship
to student
Age Enrolled in college at least half time?
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Full name of others in household for whom
student provides more than 50% support
Relationship
to student
Age Enrolled in college at least half time?
I certify that I provide more than 50% support for the individuals listed below and they
do not receive any additional state or federal benets, ie. disability, pension, or retirement.
Student Signature
Yes No College:
Yes No College:
Yes No College:
Yes No College:
1
2019/2020
Independent Professional
Judgment with Verication
Verication
The rst step of the Professional Judgment is verication of your original FAFSA information.
RESET FORM
PRINT FORM
C. 2017 Income and Tax Data
HCC ID#
PJ–Independent + Verication
VERIFICATION OF 2017 INCOME FOR STUDENT
Student worked in a FOREIGN COUNTRY in 2017.
 Student will complete Foreign Income Supplement, even if no income was earned, and provide documentation.
(Oce use only: insert FAC19FID in CRI.)
Student was employed in 2017 and led US taxes.
 Student has used/will use IRS DATA Retrieval Tool on FAFSA. OR
 Student has provided/will provide signed copy of 2017 1040, 1040A or 1040EZ tax form.
Student was not employed (in the US or any foreign country) and no income was earned from work in 2017.
Student will complete Dependent Non-Tax Filer form.
Student was employed in the US in 2017 but did not le taxes.
Student will provide copies of all 2017 IRS W-2s, if issued by employers.
Was this a work-study position? Yes No
VERIFICATION OF 2017 INCOME FOR SPOUSE
My spouse worked in a FOREIGN COUNTRY in 2017.
 Spouse will complete Foreign Income Supplement, even if no income was earned, and provide documentation.
(Oce use only: insert FAC19FID in CRI.)
My spouse was employed in 2017 and led US taxes.
 Spouse has used/will use IRS DATA Retrieval Tool on FAFSA. OR
 Spouse has provided/will provide signed copy of 2017 1040, 1040A or 1040EZ tax form.
My spouse was not employed in the US and no income was earned from work in 2017.
Spouse will complete Spouse Non-Tax Filer form (unless ling jointly).
My spouse was employed in the US in 2017 but did not le taxes.
Spouse will provide copies of all 2017 IRS W-2s, if issued by employers.
Was this a work-study position?
Yes No
2017 Filing
Requirements
for Most
Taxpayers
See IRS Publication 17
for detailed guidance or
if you are over 65.
IF your ling status is...
AND at the end of 2017
you were...
THEN le a return if your
gross income was at least...
Single Dependent under 24 $6,350
Single Independent Student under 65 $10,400
Married ling jointly under 65 (both spouses) $20,800
Married ling separately any age $ 4,050
Head of household under 65 $13,400
Qualifying widow(er) under 65 $16,750
D. Current Net Worth
as of the date fafsa was completed—
not today’s date. If you do not have any
assets in that category, enter $0. If the net
worth is negative, enter $0.
Student Parent(s)
Net Worth of Cash/Savings/Checking Accounts
Net Worth of Investment*
Net Worth of Business/ Investment Farm**
Investments include
• real estate (do not include the
home in which you live);
• rental property (includes a unit
within a family home that has
its own entrance, kitchen, and
bath rented to someone other
than a family member);
• trust funds;
• UGMA and UTMA accounts;
• money market funds;
• mutual funds;
• certicates of deposit;
• stocks;
• stock options;
parental information, the
accounts owned by the
student (and/or the student’s
spouse) are reported as
student investments in
question 42. For a student
who must report parental
information, the accounts
are reported as parental
investments in question
91, including all accounts
owned by the student and
all accounts owned by the
parents for any member of
the household.
• Money received, or paid on
your behalf, also includes
distributions to you (the
student benefciary) from a
529 plan that is owned by
someone other than you or
your parents (such as your
grandparents, aunts, uncles,
and non-custodial parents).
Investments do not include
• the home you live in, the value
of life insurance;
• retirement plans
(401[k] plans;
• pension funds;
• annuities;
• noneducation IRAs, Keogh
plans, etc.);
• cash, savings and checking
accounts already reported in
questions 41 and 90;
• UGMA and UTMA accounts for
which you are the custodian,
but not the owner. Investment
value means the current
balance or market value of
these investments as of today.
Investment debt means only
those debts that are related to
the investments.
Continued on page 3
Enter the net worth of assets when the FAFSA was completed.
Net worth means the current value, as of today, of investments,
businesses, and/or investment farms, minus debts related to those same investments, businesses, and/or investment farms. When
calculating net worth, use 0 for investments or properties with a negative value.
• bonds;
• other securities;
• installment and land
sale contracts (including
mortgages held);
• commodities, etc.
• qualifed educational benefts
or education savings
accounts (e.g., Coverdell
savings accounts;
• 529 college savings plans
and the refund value of 529
prepaid tuition plans). For a
student who does not report
PLEASE CAREFULLY READ THE NOTES BELOW AND ON THE NEXT PAGE, EXPLAINING THE CRITERIA FOR EACH ASSET.
EXPLANATION OF CIRCUMSTANCES
Explain your circumstances, including specic dates and details.
REASON FOR PROFESSIONAL JUDGMENT REQUIRED DOCUMENTS
Death of spouse after ling the 19/20 FAFSA.
Date of death:
Copy of the death certicate
Separation or divorce after ling the 19/20 FAFSA.
Date of marital separation:
Student’s 2017 W2(s) Spouse’s 2017 W2(s
copy of separation agreement, divorce decree, or substantial
evidence (mortgage/lease/utility bill) proving you live in
separate residences
is unemployed
or has an income reduction of at least 20% after Jan. 1, 2018.
Date of unemployment/income reduction:
(month/year)
Is above-named student/spouse employed now?

Yes No
Date of new employment:
(month/year)
2018 tax return reects current nancial situation:
Submit signed copy of 2018 1040 form: Student Spouse
Submit 2018 W2s or 1099s: Student Spouse
2018 tax return does not reect current nancial situation:
Complete the 2019 Estimated Income worksheet on page 2.
Termination letter
Last 3 pay stubs from former employer
All unemployment benets received in 2019.
(Ex. Copy of severance/ benets/unemployment compensation)
Most recent 3 pay stubs from current employer
For professional judgments processed after Jan.31, 2020, the
following additional documents may be required:
2019 W2s or 1099s: Student Spouse
Submit signed copy of 2019 1040 form: Student Spouse
2020 Estimated Income
Loss or reduction of untaxed income after January 1, 2018
(ex. IRA conversion, loss of child support, etc.)
Date of change:
Attach documentation. (Example: Ocial documentation of
termination of benets)
Unusual medical and dental expenses (Expenses paid in
2018, not covered by health/dental insurance.)
Attach supporting documentation.
(Example: Proof of payment, receipts).
Other
Documentation:
Business value DOES NOT include
• the value of a small business if your family owns and controls more than 50
percent of the business and the business has 100 or fewer full-time or full-time
equivalent employees. For small business value, your family includes (1) persons
directly related to you, such as a parent, sister or cousin, or (2) persons who are
or were related to you by marriage, such as a spouse, stepparent or sister-in-law.
Investment farm value does not include the value of a family farm that you (your
spouse and/or your parents) live on and operate
Business and/or investment farm value includes
• the market value of land, buildings, machinery, equipment, inventory, etc.
Business and/or investment farm debt means only those debts for which the
business or investment farm was used as collateral.
Professional Judgment
Continued from page 2
Certication and Signature
Each person signing below certies that all of the information reported is complete and correct. If student is
dependent, the student and one parent whose information was reported on the FAFSA must sign and date.
Student’s Signature
Date
WARNING: If you purposely give false or misleading information, you may be ned, sent to prison, or both.
Financial Aid Services
10901 Little Patuxent Pkwy 443-518-1260
Columbia MD 21044 443-518-4576 (fax)
CRI: FAC19PJY
ImageNow Doc type: UG Finaid Verication
FA Doc Name: Professional Judgment
Work Flow Main: FAS Document Processing
Work Flow Sub-queue: Academic Year
2019—OTHER RESOURCES TYPE OF SUPPORT WHO RECEIVES THE SUPPORT?
AMOUNT EXPECTED IN 2019
Provide information about any
other resources, benets, and
other amounts received by the
student and any members of
the student’s household.
Legal Settlement
$
Medical Assistance
$
SSI/SSDI
$
Savings
$
SNAP
$
WIC
$
Total $
Estimated Income your family expects to receive from January 1, 2019 through December 31, 2019
WHAT IS YOUR 2019 ESTIMATED GROSS TAXABLE INCOME?
STUDENT SPOUSE
2019 wages, salaries, tips YTD (year to date) earnings from pay stubs in 2019
$ $
2019 Estimate Earnings:
Student: Average earnings per pay period in 2019 = X No. of pay periods remaining in 2019 =
Parent: Average earnings per pay period in 2019 = X No. of pay periods remaining in 2019 =
$ $
Add 2019 YTD earnings + 2019 estimated future earnings = Total estimated wages for 2019
$ $
Do you or your spouse receive money from pensions and annuities? No Yes $ $
Do you or your spouse have income from Interest, dividends, and capital gains? No Yes
$ $
Do you or your spouse have business or farm income? No Yes
$ $
Do you or your spouse receive taxable Social Security benets ? No Yes
$ $
Do you or your spouse have rental income (after expenses such as mortgage interest, taxes, etc)? No Yes
$ $
Do you or your spouse receive Alimony? No Yes
$ $
Do you or your spouse receive unemployment compensation No Yes
$ $
Do you or your spouse receive any other taxed income, e.g., severance pay? No Yes
$ $
Total 2019 Estimated Taxed Income (1–9)
$ $ $
WHAT IS YOUR 2019 ESTIMATED UNTAXED INCOME?
STUDENT SPOUSE
Money received by student (do not include money received from parent listed on FAFSA)
$ $
Money paid on student’s behalf (e.g., bills)
$ $
Payment to tax-deferred pension and savings plans (from W-2 forms in Boxes 12a –12d, codes D,E,F,G,H and S)
$ $
Deductible IRA and/or Keogh, SEP, and SIMPLE payments
$ $
Child Support received for all children
$ $
Tax-exempt interest income
$ $
Untaxed portions of IRA distributions
$ $
Living and housing allowances for clergy, military and others*
$ $
Veteran’s Non-educational benets**
$ $
Any other untaxed income and benets not reported elsewhere on this form***
$ $
Total 2019 Estimated Untaxed Income (1–10)
$ $ $
In sections A and B, report estimated income before exemptions, adjustments, or deductions.
If there will be no income in a category, enter “0.
”
*
Include cash payments or cash value of benets. Exclude rent subsidies for low-income housing. Members of the military should only report their total BAS benets for 2018.
Do not report any military housing benets (BAH, BAQ, or the value of on-base military housing).
** Include Disability, Death Pension, or Dependency & Indemnity Compensation (DIC) and /or VA Educational Work-Study allowances
*** Include untaxed income such as workers’ compensation, disability benets, Black Lung Benets, untaxed portions of health savings accounts, Railroad Retirement benets, etc.
NOTE: If you are submitting a 2018 tax return transcript, do not complete this step.
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Completed 23 July 2020

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