Fillable Noncustodial Parent 1819

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Noncustodial Parent 1819

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Noncustodial Parent Form
2018-19 Academic Year
INSTRUCTIONS
This form should be submitted by the noncustodial parent for all first-time undergraduate financial assistance applicants whose parents
are separated, divorced, or were never married and are not living together. This includes first-year and transfer applicants to our 2018–
2019 entering class and current students wishing to apply for financial assistance at the University of Dayton for the first time. The
student and parent(s) should work together to complete this form. The information provided will be used to determine the student’s
eligibility for non-merit, university-funded need based aid only.
STUDENT INFORMATION
Student’s Name Student ID#
Last First MI
Permanent Address
Street Address City State Zip
SSN (optional) ________________________ Home Phone ______________________ Cell Phone ____________________
The following section should be completed by the noncustodial parent and should include current spouse, if applicable.
NONCUSTODIAL PARENT INFORMATION
Name of noncustodial parent ___________________________________________________ Birthdate ____________________
Last First MI MM/DD/YYYY
Permanent Address
Street Address City State Zip
Email address _______________________________________ Phone number _________________________________________
Current Marital Status (mark one): Married Divorced Separated Widowed Single (never married)
Number in current household _______
1) 2016 Noncustodial Parent’s Support of Former House
hold:
a) Did you claim the student above as a dependent on your 2016 U.S. income tax return? Yes No
b) Annual Child Support Paid for All Children $ ______________________
c) Annual Child Support Paid for the Student Applicant $ ______________________
d) When will (did) the student applicant’s support end? ______________________
e) Alimony Paid $ ______________________
f) How much support do you expect to contribute per year to the
student applicant’s education, excluding child
support? $ ______________________
g) Is there an agreement specifying this contribution to the student’s education? Yes No
h) How many children in your family, including the student above,
will be attending college at least half-time* during the 2018–19 academic year? _______
* This shoul
d include any children under the age of 24 whom you share with the student’s custodial parent, even if they do not live with you,
and anyone who does live with you or receives more than 50% of his or her support from you and your current spouse (if applicable).
Office of Financial Aid
300 College Park
Dayton, Ohio 45469 -1605
FAX: 937-229-4338
finaid@udayton.edu
www.finaid.udayton.edu
Please complete next page
Noncus
todial Parent Form, cont.
NONCUSTODIAL PARENT FINANCIAL INFORMATION
Help & Hints for questions in this section:
3) 2016 Taxable Income
a. Wages: Enter amount from line 7 on IRS Form 1040, or line 7 on IRS Form 1040A, or line 1 on IRS Form 1040EZ.
b. Spouse Wages: Enter amount from line 7 on IRS Form 1040, or line 7 on IRS Form 1040A, or line 1 on IRS Form 1040EZ.
c. Adjusted Gross Income (AGI): Enter amount from line 37 on IRS Form 1040, or line 21 on IRS Form 1040A, or line 4 on IRS Form 1040EZ.
4) 2016 Federal Income Tax: Enter amount from line 56 minus line 46 on IRS Form 1040, or line 37 minus line 29 on IRS Form 1040A, or line 10 on
IRS Form 1040EZ.
5) 2016 Untaxed Income
a. Child Support Received: Include all untaxed child support received, even if the parent will not receive that child support in future years.
b. Contributions to IRAs: Enter amount from line 28 and 32 on IRS Form 1040, or line 17 on IRS Form 1040A. Enter payments to tax-deferred
pension and retirement savings plans (paid directly or withheld from earnings) to IRAs, 401k plans, 403b plans, etc. The amount reported
should NOT represent the total value in these accounts. The amount reported should represent the total amount of before-tax contributions
to IRA, 401k, and 403b savings plans earned in 2016.
c. Other Tax Exempt Income: Enter any other tax exempt income. Do not include Social Security benefits.
6) Enter the total of cash, savings, and checking accounts. Do not include certificates of deposit (CDs) or money market accounts.
7) Enter the net asset value of all stocks, bonds, investments and real estate equity. Investments include trust funds, UGMA and UTMA accounts,
money market funds, mutual funds, certificates of deposit (CDs), stocks, stock options, bonds, other securities, Coverdell savings accounts, 529
college savings plans, the refund value of 529 state prepaid tuition plans, installment and land sale contracts (including mortgages held), commodities,
etc. The net asset value is an asset’s market value minus any debt against that asset. Do not include any assets in defined retirement plans (IRAs,
401k plans, 403b plans, etc.).
8) Enter the market value less debt of land, buildings, machinery, equipment, inventory, etc. Business value does not include the value of a small
business if your family owns and controls more than 50 percent of the business and the business has 100 or fewer full-time or full-time equivalent
employees. For small business value, your family includes (1) persons directly related to you, such as a parent, sister or cousin, or (2) persons who
are or were related to you by marriage, such as a spouse, stepparent or sister-in-law. Investment farm value does not include the value of a family
farm that you live on and operate.
2) 2016 tax filing status: I have filed my return. I will file but have not yet filed my return. I did not/will not file.
3) 2016 Taxable Income (whole dollars only)
a) Wages of Student’s Noncustodial Parent $ ______________________
b) Wages of Student’s Noncustodial Parent’s Spouse $ ______________________
c) Adjusted Gross Income (AGI) $ ______________________
4) 2016 Federal Income Tax $ ______________________
5) 2016 Untaxed Income
a) Child Support Received for All Children $ ______________________
b) Contributions to IRAs, 401k and 403b plans, etc. $ ______________________
c) Other Tax-Exempt Income $ ______________________
6) As of today, what is the value of your cash, savings and checking accounts? $ ______________________
7) As of today, what is the current net value of your stocks, bonds, investments
and real estate? $ ______________________
8) As of today, what is the net worth
(market value less amount owed) of your current
business and/or investment farm? $ ______________________
a) Do you own more than 50% of the business and/or investment farm reported and
does it have fewer than 100 employees? Yes No
Signature - REQUIRED
I hereby affirm that all information reported on this form and any attachment hereto is true, complete, and accurate to the best of my
knowledge.
Noncustodial Parent Date
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Noncustodial Parent 1819

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Completed 25 February 2020

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