Upon reviewing your 2019-2020 FAFSA results, we must verify your reported Taxable Grant and Scholarship Aid reported to the IRS as
income, as reported under the ‘2017 Additional Financial Information’ sections of your FAFSA. Please provide us with the information
requested below within 30 (thirty) days to finalize your eligibility for aid. Failure to comply may jeopardize your award for the year.
Student’s Name Student ID#
Last First MI
Permanent Address
Street Address City State Zip
SSN (optional) ________________________ Home Phone ______________________ Cell Phone __________________
2017 ADDITIONAL FINANCIAL INFORMATION
Taxable College Grant and Scholarship Aid reported to the IRS as Income. Includes
AmeriCorps benefits (awards, living allowances and interest accrual payments), as well
as grant and scholarship portions of fellowships and assistantships.
(As it relates to questions 44d and 93d on FAFSA)
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 (if dependent) Date
Office of Financial Aid
300 College Park
Dayton, Ohio 45469-1605
TEL: 937-229-4311 FAX: 937-229-4338
flyerstudentservices@udayton.edu
Grant & Scholarship Aid Form
2019-2020 Academic Year
