Fillable FormACTEXP Financial Aid Form

Fill Online, Printable, Fillable, Blank FormACTEXP Financial Aid Form Form

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FormACTEXP Financial Aid Form

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The FormACTEXP Financial Aid Form form is 2 pages long and contains:

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File type: PDF

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WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or both.
(v. 12/06/2018) Page 1 of 2 (S:\20_Forms\formACTEXP.wpd)
FORM ACTEXP - IDAHO STATE UNIVERSITY 19-20
STATEMENT OF ACTUAL STUDENT EXPENSES
DURING THE SCHOOL YEAR 2019-2020
Although Idaho State University uses average costs to determine your standard cost of
attendance, additional costs may be allowed on a case by case basis. Please provide
information regarding your actual student expenses by completing this form and
following the instructions below.
Office of Financial Aid, Idaho State University, Museum Building, Room 337
921 S 8
th
Ave, Stop 8077, Pocatello, ID 83209-8077
Email: finaidem@isu.edu Phone: (208)282-2756 Fax: (208)282-4755
Web: https://www.isu.edu/financialaid/forms/
University Place, Bennion Student Union Building, Student Services Office
1784 Science Center Dr, Idaho Falls, ID 83402 Phone: (208)282-7704
ACTEXP-20
*Student Name:
(Use blue or black ink) Last First M.I.
*ISU ID: *Last 4 Digits of Social Security #:
(Find under Academic Tools tab on BengalWeb)
Address:
Street City St Zip
*Required
1. Complete page 2 and attach any required documentation. Schedule an appointment with a financial aid
counselor (see #2 below). You must bring your completed Statement of Actual Student Expenses form and
all required documentation to your appointment. Your request will not be considered unless you provide
adequate, appropriate documentation and meet with a counselor f
rom the Office of Financial Aid.
2. Schedule an appointment with a Financial Aid Counselor.
Call the Office of Financial Aid at (208)282-2756, or come to the office in room #337 of the Museum Building, to
schedule an appointment. If you are a student on the Idaho Falls campus, call (208)282-7800, or come to the
Bennion Student Union Building Student Services Office.
3. The Financial Aid Counselor you meet with will determine applicable costs that will be allowed.
OFFICE USE ONLY
COMMENTS:
Administrator Date
STATEMENT OF ACTUAL STUDENT EXPENSES
Please fill in blanks, print, sign, attach docs & return
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WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or both.
(v. 12/06/2018) Page 2 of 2 (S:\20_Forms\formACTEXP.wpd)
DURING SCHOOL YEAR 2019-2020
Expenses:
Monthly
Amount
OFFICE
USE
ONLY
Rent/Mortgage (Attach documentation)........................
$ $
Utilities:(Attach documentation)
Electricity ...........................................
Heat ...............................................
Sewer, water, & garbage ...............................
Internet service ......................................
Telephone ..........................................
$
$
$
$
$
$
$
$
$
$
Transportation:
Commuter bus fare (Attach receipts) .....................
Commuter costs......................................
Days per week (Fall Semester)
Days per week (Spring Semester)
Days per week (Summer Session)
Miles per day
Commuting from to
$
$
$
$
Child Care (Attach a bill of charges to date or monthly bill or letter from
provider outlining hours and charges per day, week or month.)
Day Care Provider
Names of children in daycare
$ $
Personal:
Medical insurance (Attach documentation) ................
Medical/Dental Expenses (Attach documentation) ..........
Miscellaneous. .......................................
Books (Attach documentation)...............................
$
$
$
$
$
$
$
$
Other miscellaneous expenses (Attach documentation): Do not
include credit card bills, car payments, or car insurance.
$ $
$ $
Total: $ $
CERTIFICATION: The person signing below certifies that all of the information reported is complete
and correct.
Student Signature: Date:
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FormACTEXP Financial Aid Form

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Completed 6 November 2019

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