(10‐15‐19)
Student Asset Worksheet 2020-2021
Please answer all lines with the total amounts for the year.
(If none, respond with 0. If not applicable, respond with N/A.)
Student
Cash, Savings, Checking as of Today
$
Investment Net Worth as of Today
$
Business and Farm Net Worth as of Today
$
2018 Education Tax Credits
$
2018 Child Support Paid
$
2018 Need Based Employment (Work study)
$
2018 Grant and Scholarship Aid (amount reported as income)
$
2018 Combat Pay
$
2018 Co-op Earnings
$
2018 Tax Deferred Pensions
$
2018 IRA Deductions and Payments
$
2018 Child Support Received
$
2018 Tax Exempt Interest
$
2018 Untaxed Portions of IRA Distributions
$
2018 Untaxed Portions of Pensions
$
2018 Military and Clergy Allowance
$
2018 VA Non-Education Benefits
$
2018 Other Non-Taxed Income
$
2018 Other Non-Reported Money
$
Certifications and Signature
The person signing below certifies that all of the
information reported is complete and correct.
Print Student’s Name: __________________________ Student’s ID# __________________
Student’s Signature
(Required): __________________________ Date: ________________
WARNING: If you purposely give false or
misleading information, you may be fined,
sent to prison, or both.
click to sign
signature
click to edit
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