You are on page 1of 2
UNITED STATES DEPARTMENT OF EDUCATION 1-800-4-FED-AID (1-800-433-3243 or TTY: 1-800-730-8913) We Help Put America Through School OME Ne www.fafsa, [es —_t 0001170041 CHRISTOPHER E, STUDENT 1234 ABCDEFGHUKLMNOPQRSTUVWXYZABCDE. June 27, 2004 ABCDEFGHUKLMNOP®, MD 12345 EFC: 00000* C Dear CHRISTOPHER E. STUDENT, Thank you for submitting your information for federal student aid to the U.S. Department of Education, This is your Student Aid Report (SAR) information Acknowledgement for the 2004-2005 award year. Keep copy of this SAR Information Acknowledgement for your records. We have processed your application for federal student aid or the correction that you submitted electronically through your school ot on the Web. On the back of this page we printed the information we received and a summary of the results of processing that information. We may have assumed certain information to calculate your eligibilly fot federal student aid. We printed any assumptions we made and ‘the word "assumed! for the items on the back of this page. You can make corrections by going to and using your PIN or by contacting your Financial Aid Administrator (FAA) ft =the assumptions we made are not correct, - you need to make other corrections, or = we indicate below that more information is needed to determine your eilgiblty. Contact your FAA if: = we indicate below you are selected for verification, or - we indicate below you must work with your FAA to resolve some elighilly Issues. Based on the information you gave us, you are not eligible for a Federal Pell Grant. However, you may be eligible for other types of aid, Your application has been selected for a review in a process called verification, Your school has the ‘authority fo request copies of certain financial documents from you DRN: 2401 999999¢999 PAGE 1 OF 2 123-45-6789 ST 01 ‘This section contains information from your student sid application (shaded items digplay parents’ information, it provided). If you n te make corrections, see the financial aid administrator at your school TST ECOEFSTE LAO ‘53 PARENTS DECEASED GR WARD OF COURT? 2. FIRST NAME ‘ABCOEFGIE KL, ‘56. VETERAN OF U.S. ARMED FORCES? 3 MIOOLE INITIAL * = ae mara I. RLPOOPORSTOWTZARE Tao ced cry — ‘ASCOEFGHKLMIOPO eesan ‘6 STATE ABBREVIATION ro ‘ett et T=EIP_cO0E as eget saea ‘8 SOCTAL SECURITY WORE 12-15-4789 = ae '9._DATE OF BIATH “AWARY 01, 964 = aera 0: PERVANENT HONE PRONE HORDE 19991999-9999. | onesies — i, DRIVER'S LICENSE WUNGER 1234-456-789-01 34 | Bo ieiline 2; DRIVER'S LICENSE STATE amaREVEATTON [Al 1 = Tees 19,_ST_E-MATL[CHRISTOPHER. E, STUDENTBUNIVAD. CAMPUS, COLLGPRE. EDU = a 14, CITIZENSHIP STATUS (ELI. WONCTT ASSUMED) — — cs 35._ALTEN REGISTRATION WBE ‘A123KB6709 = ie: WARITAL STATUS THARRLED_ASSIRED) — [37 OATE OF WARITAL-STATUS sana 1992 = STATE. OF LEGAL RESIDENCE ABBREVIATION [AB mises 19. LEGAL RESIDENT BEFORE JANUARY 1, 19999] (Blt) [zo DATE YoU BECAME 4 LEG. RESIDE x 220 Te [2a._REGISTER You Fou seLecTive SERVICE? —| Ee 2a._1VPE OF DeGREE/CERTIFTCATE — 26. GRADE LEVEL TW COLLEGE TN 2004-7005 25. HIGH SCHOOL DIPLOMA OF GED? 26, FINST BACHELORS DEGREE BY 7=1-20007 Ge cseriaaias '27<—IWTERESTED IW STUDENT LOAN? — — 28, INTERESTED TW WORK-STUOY? es [29 FATHER'S EDUCATIONAL LEVEL —————| 1 = = —— 30,_ MOTHER'S” EDUCATTONAL LEVEL COLLEGE ee meee 31, DAUG CONVICTION AFFECTING ELTGIBILITV?| €T61aL€ FOR ATO | ic —— 32; FILED 2003 TRS TWCOME TAX RETURN — [WILL FILE | [eke WNGER OF FAMILY MENBERS IN 2004-7005 0 33. TYPE OF 2003 TAX FORM USED U.§. TRUST TERATTORY MGER_IN-COLLEGE TN 2004-2005 “Tz 96; ELIGIBLE To FILE-A 1040n. 08 i0sOEz? | (GLARE) “| [aescrtasT COLLEGE woe [173456 7a90170056 76901204567E9012 9056 [35 ADUSTED GROSS INCOME FROM IRS FORM | § _(-129,456 ASSUMED] FIST HOUSING PLANS WITH PARENT '36:_U.S._ INCOME TAX PAID '¢ —_ (42,345 ASSUMED) 'SECOMD COLLEGE wine —|-12945678901254567090TZS45CTESOLZINSS [37 EXENPTIONS CLAIMED $0 'SECOND-HOUSTNG_PLANS_|_WITH PARENT 38. STUDENT'S income EARNED PRON ORK T's —(aza,aa6_AsSinEO) —| [0.~Thaww COLLEGE MARE 9 OLE STEROL HIST OTOL '39._SPOUSE'S INCOME EARNED FON WORK | S (123,456 ASSIMED) | [91.—THINO HOUSING PLANS | WITH PaREWT 40. AWOUNT_FROW FAFSA WORKSHEET _& Sas 92;_FOURTH COLLEGE WANE —|~123456789012305679901201507ADOTIIASG FRO SHEET & [62 AMOUNT FROM FAFSA WORKSHEET € 49._CASH, SAVINGS, AND_ CHECKING [s4<_MET NORTH OF THVESTHENTS 5._WET WORTH OF BUSIWESS /INVESTHENT FARIS| 46 a FOURTH WOUSING_PLANS [WITH PAREMT | [4s FLFTW COLLEGE wwe | T2asserasorza4seTeO1z ESTATES 95._FIFTH ROUSING-PLAnS—T WITH PARENT ——— | 36: Soc COLLEGE Mane | 123458749012345eTRsOTzSIsCTAROIZ ES 97. SIXTH HOUSING-PLARE [WITH PARENT HOM MAK MONTHS. RECEIVE VA_ BENEFITS? WONTHLY Vk EDUCATION BENEFITS ANOUNT BORN BEFORE 1-1-1961? —h WORKING ON RASTER'S OR DOCTORATE 50. ARE YOU WARRIED? '51._HAVE CHILDREN YOU SUPPORT? 52; DEPENDENTS OTHER THAN CHILDREN/SPOUSE?| PARENT'S E-WAIL. ADDRESS: CHRISTOPHER. STUDENTS. HOTHEROHOME. COMCAST COM “ATTENDING THE 2004-2005 ACADEMIC YEAR [FULL TIRE 99._DATE. COMPLETED. “UMURRY 1, 7006 loo. steweD oy — ‘STUDENT lot. PREPARERS” SOCTAL_SECURITY WBE REPORTED | fida:_PRerameR's ern REPORTED, [ns PREPARER'SSTOHATURE ~SroNED For Financial Aid Office Use Only Transaction Source: xx Expected Family Contribution: Primary 00000 Dependency Status: x Verification Flag: x ‘Secondary 00000 — Dependency Override: x SAR C Flag. y Automatic Zero EFC Flag x Hold Code: x System Generated Indicator: X Formula Type x Pell Eligible Flag: x ‘Application Receipt Date: mm/dd/ceyy Simplified Needs Test Flag: x ‘Transaction Process Date: mm/dd/ceyy FAA Adjustment: x Transaction Receipt Date: mm/dd/ceyy SSN Match Flag: x Selective Service Registration Flag X Selective Service Mate: X DHS Match Flag: x DHS Verification #: 989999999999999 SSA Citizenship Goce: x DHS Sec. Cont. Flag: x VA Match Flag: x FSSN Matgh Flag! x NSLDS Match Flag: x NSLOS Resuits Flag x MSSN Match Flag: x NSLOS Transaction Number: x Relect Codels: 01 02 03 04 05 06 07 Comment Codes: 001 002 003 004 005 006 007 008 009 010 O11 012 013 014 O15 016 017 018 019 020 999999¢999 PAGE 2 OF 2 123-45-6789 ST 01