2019–2020 Parent Additional Financial Information Form
Your FAFSA application was selected by the U.S. Department of Education for review after comparing your parent(s) 2017
Adjusted Gross Income and other financial information. BRCC is required by federal law to compare the FAFSA with the
information on this worksheet. You, your parent, and parent’s spouse if married, must complete this form. You and your parent
must sign and submit the form to the Financial Aid Office to determine eligibility for federal student aid. Incomplete forms or
conflicting information will cause delays in the processing of your aid. Instructions for looking up your Student I.D. can be
found here: Find your student ID here.
A. Student Information
Last Name: ______________________________________ First Name: __________________________________________
Student ID (required): _________________ Date of Birth: _________________ Phone Number: ______________________
B. Additional Financial Information:
Report total annual amounts for 2017. If an item does not apply use “0” or “N/A.”
Additional Financial Information to Verify:
Parent(s) Total
2017 Amount:
Education credits (American Opportunity Tax Credit and Lifetime Learning Tax Credit).
Amount found on IRS Form 1040 – line 50 or IRS 1040A – line 33.
Child Support Paid. List amount paid due to a divorce or separation as a result of a legal
requirement. Don’t include support for children included in parent’s number in household.
Child or children support is paid for: _______________________________________________
_______________________________________________________________________________
Adult support is paid to: __________________________________________________________
Taxable Earnings from Need-Based employment programs. Include amounts from Federal Work-
Study, and assistantships or fellowships, if they are need-based.
Taxable college grant and scholarship aid, only if it was reported to the IRS in your Adjusted Gross
Income. Include amounts from AmeriCorp benefits (awards, living allowances, and interest accrual
payments), as well as grant and scholarship portions of fellowships and assistantships.
Combat pay or special combat pay. Only enter the amount that was taxable and included in the
Adjusted Gross Income on the 2017 tax form filed. Don’t include untaxed combat pay.
Earnings from work under a cooperative education program offered by a college.
C. Certification and Signatures
The student and the parent for whom information is provided above MUST sign and date this section in blue or black ink. Each
person signing below certifies that all the information reported on this form is complete, correct, and any additional information is
attached, if necessary. WARNING: If you purposely give false or misleading information on this worksheet you may be
fined, sentenced to jail, or both.
Student Signature: _____________________________________________ Date: ____________________
Parent Signature: ______________________________________________ Date: ____________________
Please return this completed form in one of the following ways: upload it using the link to the form on your To-Do list in SIS, fax
to 540-234-8189, scanned e-mail attachment to finaid@brcc.edu, or mail to Blue Ridge Community College, Office of Financial
Aid, Box 80, One College Lane, Weyers Cave, VA 24486. Please call 855-844-3631 if you have questions.
