Fillable HOUSEHOLD INFORMATION FOR 2021-2022 DEPENDENT STUDENTS If the (State University of New York at Plattsburgh)

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HOUSEHOLD INFORMATION FOR 2021-2022 DEPENDENT STUDENTS If the (State University of New York at Plattsburgh)

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R
evised: 12/01/2019 FAMSZD
Financial Aid Office • SUNY Plattsburgh • 101 Broad Street • Plattsburgh, NY 12901-2681
Tel: (518) 564-2072 • Toll-Free: (877) 768-5976 • Fax: (518) 564-4079 • email: finaid@plattsburgh.edu
HOUSEHOLD INFORMATION FOR 2021-2022
Student Name: ___________________________ Banner ID or NetID: ____________________________
If the federal government considers you dependent for financial aid purposes, complete the section below for
Dependent Students (most students at Plattsburgh are dependents). If the federal government considers you
independent for financial aid purposes, complete the section on the opposite page for Independent Students.
DEPENDENT STUDENTS
Only complete this section if you are dependent for financial aid purposes. In the table below, list the people in
the household of your legal parents. A legal parent is your biological or adoptive parent, or your legal parent
as determined by the state (for example, if the parent is listed on your birth certificate). If you have a stepparent
currently married to your
legal parent, you generally also must provide information about them. Include in the
table below:
(a) yourself and your parent(s) (including stepparent) even if you don’t live with your parents; and
(b) your parents’ other children, even if they don’t live with your parent(s), if (1) your parents provide more than half
of their support from July 1, 2021 through June 30, 2022, or (2) the children would be required to provide parental
information when applying for Federal student aid; and
(c) other people if they now live with your parents, and your parents provide more than half of their support and will
continue to provide more than half of their support from July 1, 2021 through June 30, 2022
(d) Also, write in the name of the college for any family member, excluding your parent(s), who will be attending
college at least half-time between July 1, 2021 and June 30, 2022, and will be enrolled in a degree, diploma, or
certificate program
Full Name
Age
Relationship
College Enrolled in 2021-2022
Will be Enrolled at
Least Half-Time?
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
SIGNATURE
By signing this worksheet, I certify that all the information reported is complete and accurate. If false or
misleading information is purposely provided on this worksheet or on the Free Application for Federal Student
Aid, I understand I may be fined, be sentenced to jail or both.
Student Ink Signature Date
Parent Ink Signature Date
Financial Aid Office • SUNY Plattsburgh • 101 Broad Street • Plattsburgh, NY 12901-2681
Tel: (518) 564-2072 • Toll-Free: (877) 768-5976 • Fax: (518) 564-4079 • email: finaid@plattsburgh.edu
R
evised: 12/01/2019 FAMSZD
S
tudent Name: ___________________________ Banner ID or NetID: ____________________________
I
f the federal government considers you independent for financial aid purposes, complete the section below for
Independent Students. If the federal government considers you dependent for financial aid purposes,
complete the section on the opposite page for Dependent Students (most students at Plattsburgh are
dependents).
INDEPENDENT STUDENTS
Only complete this section if you are independent for financial aid purposes. In the table below, list the people
in your household. Include:
(a) yourself and your spouse if you have one; and
(b) your children, if you will provide more than half of their support from July 1, 2021 through June 30, 2022; and
(c) other people if they now live with you and you provide more than half of their support and will continue to provide
more than half of their support from July 1, 2021 through June 30, 2022
(d) Also, write in the name of the college for any family member, who will be attending college at least half-time
between July 1, 2021 and June 30, 2022, and will be enrolled in a degree, diploma, or certificate program
Full Name
Age
Relationship
College Enrolled in 2021-2022
Will be Enrolled at
Least Half-Time?
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
SIGNATURE
By signing this worksheet, I certify that all the information reported is complete and accurate. If false or
misleading information is purposely provided on this worksheet or on the Free Application for Federal Student
Aid, I understand I may be fined, be sentenced to jail or both.
Student Ink Signature Date
Spouse Ink Signature if married Date
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HOUSEHOLD INFORMATION FOR 2021-2022 DEPENDENT STUDENTS If the (State University of New York at Plattsburgh)

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Completed 1 February 2021

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