Fillable J. Sargeant Reynolds Community College E: findaid@reynolds.edu 1651 (J Sargeant Reynolds Community College)

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J. Sargeant Reynolds Community College E: findaid@reynolds.edu 1651 (J Sargeant Reynolds Community College)

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The J. Sargeant Reynolds Community College E: findaid@reynolds.edu 1651 (J Sargeant Reynolds Community College) form is 2 pages long and contains:

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  • 8 check-boxes
  • 65 other fields

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File type: PDF

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BROWSE J SARGEANT REYNOLDS COMMUNITY COLLEGE FORMS

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Office of Financial Aid Fax: 804-371-3739
J. Sargeant Reynolds Community College E: findaid@reynolds.edu
1651 E. Parham Rd., T: 855-874-6682
Richmond, VA 23228
Georgiadis Hall
Room 202
1 of 2 Student Name Student ID
Pa
rent Monthly Income and Expense Statement
St
udent Name Student ID
A. Monthly Expenses
• Next to each item, fill in the dollar amount of your family’s average monthly expenses.
• If your family shares expenses with others, indicate only that portion of expenses, which
your family pays.
• If an expense occurs other than monthly, convert it to a monthly average.
• Fill in all items. If an item does not apply, indicate this by writing “N/A.”
Does your family share living expenses with others? Yes No
If yes, provide the name and relation to the student, if any:
Does your family pay rent? Yes No
Does your family pay a mortgage? Yes No
If “No” to both, provide an explanation of housing expenses:
2019 Average Amount Per
Month
2020 Average Amount Per
Month
Home Mortgage/Rent
$
$
Other Mortgage/Rent
$
$
Business Mortgage
$
$
Food and Household Supplies
$
$
Clothing
$
$
Utilities (Gas, Electric, Phone,
Water, Heating)
$
$
Gasoline and Auto Maintenance
$
$
Public Transportation
$
$
Medical/Health Expenses Not
Covered by Insurance
$
$
Contributions to Retirement
Accounts
$
$
Other (please specify):
$
$
Other (please specify):
$
$
Other (please specify):
$
$
Other (please specify):
$
$
TOTAL MONTHLY EXPENSE
$
$
Parent Income and Expense Worksheet
A. Monthly Expenses
Office of Financial Aid Fax: 804-371-3739
J. Sargeant Reynolds Community College E: findaid@reynolds.edu
1651 E. Parham Rd., T: 855-874-6682
Richmond, VA 23228
Georgiadis Hall
Room 202
Student Signature
2 of 2
Date
B. Sour
ce of Income
Please list all sources of income, such as the gross amount of income from work (before taxes and
deductions), unemployment benefits, disability benefits, credit card advances, personal loans, gifts
from family members, savings, business draws, rental income, earned interest or dividend.
The Office of Financial Aid will calculate your taxes as part of the evaluation for financial aid.
SOURCE OF INCOME (Please
specify)
2019 Average Amount per
Month
2020 Average Amount per
Month
$
$
$
$
$
$
$
$
$
$
TOTAL MONTHLY INCOME
$
$
C. Othe
r Assistance Sources
Are any of your family’s expenses paid by another person or organization? Yes No
If yes, complete below.
Expense Paid and Name of
Person(s)/Organization(s)
Paying for It
2019 Average Amount per
Month
2020 Average Amount per
Month
D. Certific
ation
By signing this statement, we certify that all the information reported on this form in support of the
student’s application for financial assistance is complete and correct to the best of my/our
knowledge
Parent S
ignature Date
B. Source of Income
C. Other Assistance Sources
D. Certification
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Completed 27 July 2020

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