INSTRUCTIONS
Upon reviewing your 2019-2020 FAFSA results, we must now request your asset information so we can finalize your financial aid
eligibility. Please complete and submit this form to us within 30 (thirty) days to avoid delay in receiving your aid. Failure to comply may
jeopardize your award for the year.
STUDENT INFORMATION
Student’s Name _______________________ _____________________ ______ Student ID#
Last First MI
Permanent Address __________________________________ __________________________ ___________ _______________
Street Address City State Zip
SSN (optional) ________________________ Home Phone ______________________ Cell Phone ____________________
CURRENT ASSET INFORMATION
See next page for further notes on reporting your correct asset net worth.
Student / Spouse Assets (all students)
Amount
Parent(s) Assets (dependent students only)
Amount
Total current balance of cash, savings and
checking accounts
$ _____________
Total current balance of cash, savings and
checking accounts
$ _____________
Current net worth (value minus debt) of
investments / real estate
$ _____________
Current net worth (value minus debt) of
investments / real estate
$ _____________
Current net worth (value minus debt) of
business and/or investment farm
$ _____________
Current net worth (value minus debt) of
business and/or investment farm
$ _____________
Failure to provide the requested information in a timely manner may result in a loss or reduction of financial aid.
Signature(s) - REQUIRED
I (We) hereby affirm that all information reported on this form and any attachment hereto is true, complete, and accurate to the best of
my (our) knowledge. I (We) understand that if I (we) receive federal student aid based on incorrect information, I (we) will need to repay
it; I (we) may be required to pay fines and fees.
Student Date
Parent Date
Office of Financial Aid
300 College Park
Dayton, Ohio 45469-1605
TEL: 937-229-4311 FAX: 937-229-4338
fss@udayton.edu
Family Asset Certification
2019-2020 Academic Year
STUDENT and SPOUSE ASSET INFORMATION
You must provide information about your (and your spouse’s) assets. If you are divorced or separated and you and your
spouse have jointly-owned assets, provide only your portion of the assets and debts. Be sure to list assets held in trust for
you (and your spouse).
PARENT ASSET INFORMATION
You must provide information about your parents’ assets if you are considered a dependent student for the purpose of
applying for federal, state, and university financial assistance programs. If you are providing information for only one
parent and that parent has jointly-owned assets, provide only that parent’s portion of the assets and debts.
CASH, SAVINGS, and CHECKING VALUES
Report the current balance of cash, savings, and checking accounts as of today.
INVESTMENT NET WORTH
Report the current net worth of investments held (investment value minus investment debt).
Investments include real estate*, trust funds, UGMA and UTMA accounts, money market funds, mutual
funds, certificates of deposit, stocks, stock options, bonds, other securities, Coverdell savings accounts,
529 college savings plans, the refund value of 529 state prepaid tuition plans, installment and land sale
contracts (including mortgages held), commodities, etc.
Investment value includes the market value of these investments as of today. Do not include the value of
life insurance, retirement plans (pension funds, annuities, non-education IRAs, Keogh plans, etc.), or
cash, savings, and checking accounts reported previously.
Investment debt means only those debts that are related to the investments.
* Do not include the home you live in.
BUSINESS NET WORTH
Report the current net worth of any business** held (business value minus business debt).
Business value includes the market value of land, buildings, machinery, equipment, inventory, etc.)
Business debt means only those debts for which the business was used as collateral.
** Do not include the value of a small business that you own and control if you have 100 or fewer full-time or full-time equivalent
employees.
INVESTMENT FARM NET WORTH
Report the current net worth of any investment farm***(s) held (investment farm value minus investment farm debt).
Investment Farm value includes the market value of land, buildings, machinery, equipment, inventory, etc.
Investment Farm debt means only those debts for which the farm was used as collateral.
*** Do not include a farm that you live on and operate.