Fillable Independent Asset Form (California State University Channel Islands)

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Independent Asset Form (California State University Channel Islands)

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FA-25 / 18-19 Page 1 of 1
2018-2019 Independent Asset Form
PLEASE RETURN THIS FORM TO THE CSU CHANNEL ISLANDS FINANCIAL AID & SCHOLARSHIPS OFFICE
One University Drive, Camarillo, California 93012-8599 financial.aid@csuci.edu www.csuci.edu/financialaid Tel: (805) 437-8530
Student Last Name
Student First Name
CSUCI ID Number
Student Phone Number
Purpose
CSU Channel Islands (CSUCI) is required to confirm this information to complete your application for financial aid.
Please complete all sections, do not leave a question blank, indicate "0" if the amount equals zero.
Confirm asset information as of the date the Free Application for Federal Student Aid (FAFSA) or Dream Act Application was filed.
Note: To calculate "Net Value" for the following questions, please take the value of the property (or business) and subtract what you
owe on it, as of the date the FAFSA or Dream Act Application was filed.
Assets
Student Assets
Spouse Assets
Total balance of Cash, Savings, and Checking Accounts ............................................
$
$
Net Investment Value .....................................................................................................
$
$
Include stocks, bonds, mutual funds, trust funds, UGMA and UTMA accounts, money
markets, CD's, education IRA's, Coverdell Savings Accounts, 539 college savings plans,
commodities, precious and strategic metals, installment and land sale contracts and other
investments. Do not include retirement accounts, life insurance plans or prepaid tuition
plans.
Net Real Estate Value .....................................................................................................
$
$
Do not include primary residence.
Net Business Value ..........................................................................................................
$
$
Include the market value of land, buildings, machinery, equipment, inventory, etc.
(Do not include a family business that employs less than 100 employees and you own and
control more than 50%).
Net Farm Value ...............................................................................................................
$
$
Exclude family farm value that you live on and operate.
Certification and Signature
The student must sign and date below. If married, the spouse's signature is optional. Each person signing this worksheet certifies that
all of the information reported on this form is true and accurate to the best of their knowledge.
WARNING:
If you purposely give false or
misleading information on this
form, you may be fined, sentenced
to jail or both.
Student’s Signature (electronic signatures not accepted)
Date
Spouse’s Signature (electronic signatures not accepted)
Date
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Independent Asset Form (California State University Channel Islands)

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Completed 23 July 2020

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