5/7/13

Application Summary Report - FAFSA on the Web - Federal Student Aid

FAFSA Summary Report

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2013-2014 APPLICATION SUMMARY REPORT

Student ID

XXX-XX-0527 LI

Student Demographics
Student Demographic Information
Student's Last Name (question 1)
Student's First Name (question 2), Student's Middle Initial
(question 3)
Student's Social Security Number (question 8)
Student's Date of Birth (question 9)
Is the Student Male or Female? (question 21)
Student's Permanent Mailing Address (question 4)
Student's Permanent City (question 5)
Student's Permanent State (question 6), Student's Permanent
ZIP Code (question 7)
Has Student Lived in State for at Least 5 Years?
Student's State of Legal Residence (question 18)
Was Student a Legal Resident Before January 1, 2008?
(question 19)

LINK
JASON
XXX-XX-0527
01/03/1988
MALE
1024 CREEK TRL
ANNISTON
ALABAMA 36206
YES
ALABAMA
YES

Student's Legal Residence Date (question 20)

Student's Permanent Home Phone Number (question 10)
Student's E-mail Address (question 13)
Student's Marital Status (question 16)

(334) 868-6445
JasonLinkxx88@gmail.com
I AM SINGLE

Student's Marital Status Date (question 17)

Does Student Want to Provide Driver's License Information?

YES

Student's Driver's License Number (question 11)

7756702

Student's Driver's License State (question 12)

ALABAMA

Student Eligibility
Student's Citizenship Status (question 14)

YES, I AM A U.S. CITIZEN (OR U.S. NATIONAL)

Student's Alien Registration Number (question 15)

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Is Student Registered With Selective Service?

YES

Register Student With Selective Service? (question 22)

High School or Equivalent Completed? (question 26)

HIGH SCHOOL DIPLOMA

Student's Grade Level in College in 2013-2014 (question 29)

ATTENDED COLLEGE BEFORE/1ST YR.

Type of Degree/Certificate (question 30)

1ST BACHELOR'S DEGREE

Interested in Work-study? (question 31)

YES

First Bachelor's Degree by July 1, 2013? (question 28)

NO

Father's Educational Level (question 24)

COLLEGE OR BEYOND

Mother's Educational Level (question 25)

COLLEGE OR BEYOND

Drug Conviction Affecting Eligibility? (question 23)

ELIGIBLE FOR AID

Student Aid Eligibility Worksheet

Has Student Received Federal Student Aid?

YES

Student's High School Name (question 27)

HOLTVILLE HIGH SCH

Student's High School City (question 27)

DEATSVILLE

Student's High School State (question 27)

ALABAMA

School Selection
School Information
First College (question 101a)
First Housing Plans (question 101b)
Second College (question 101c)
Second Housing Plans (question 101d)

JACKSONVILLE STATE UNIVERSITY (001020)

OFF CAMPUS
GADSDEN STATE COMMUNITY COLLEGE (001017)
OFF CAMPUS

Third College (question 101e)

Third Housing Plans (question 101f)
Fourth College (question 101g)
Fourth Housing Plans (question 101h)
Fifth College (question 101i)
Fifth Housing Plans (question 101j)
Sixth College (question 101k)
Sixth Housing Plans (question 101l)
Seventh College (question 101m)
Seventh Housing Plans (question 101n)
Eighth College (question 101o)

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Eighth Housing Plans (question 101p)

Ninth College (question 101q)
Ninth Housing Plans (question 101r)
Tenth College (question 101s)
Tenth Housing Plans (question 101t)

Dependency Status
Dependency Determination
Student Born Before January 1, 1990? (question 45)

YES

Is Student Married? (question 46)

NO

Working on Master's or Doctorate in 2013-2014? (question 47)

NO

Does Student Have Children He/She Supports? (question 50)

NO

Does Student Have Dependents Other than Children/Spouse?

(question 51)

NO

Is Student on Active Duty in U.S. Armed Forces? (question 48)

Is Student a Veteran? (question 49)
Parents Deceased?/Student Ward of Court?/In Foster Care?
(question 52)
Is or Was Student an Emancipated Minor? (question 53)
Is or Was Student in Legal Guardianship? (question 54)
Is Student an Unaccompanied Homeless Youth as Determined
by High School/Homeless Liaison? (question 55)
Is Student an Unaccompanied Homeless Youth as Determined
by HUD? (question 56)
Is Student an Unaccompanied Homeless Youth as Determined
by Director of Homeless Youth Center? (question 57)
Student's Number of Family Members in 2013-2014 (question
93)

Student's Number in College in 2013-2014 (question 94)

Answer Questions About Parents?

NO

Financial Information
Student Financial Information
Student Filed 2012 Income Tax Return? (question 32)

ALREADY COMPLETED

Student's Type of 2012 Tax Form Used (question 33)

IRS 1040A OR 1040EZ

Student's 2012 Adjusted Gross Income (question 35)

$1,815

Student's 2012 Income Earned from Work (question 38)

$1,815

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Spouse's 2012 Income Earned from Work (question 39)

Is Student or Spouse a Dislocated Worker? (question 100)

NO

Student Received Supplemental Security Income? (question 95)

Student Received SNAP? (question 96)
Student Received Free/Reduced Price Lunch? (question 97)
Student Received TANF? (question 98)
Student Received WIC? (question 99)
Student Eligible to File a 1040A or 1040EZ? (question 34)
Student Financial Information (continued)
Student's 2012 U.S. Income Tax Paid (question 36)

$0

Student's 2012 Exemptions Claimed (question 37)

Student's Education Credits (question 43a)

$0

Student's Child Support Paid (question 43b)

$0

Student's Taxable Earnings from Need-Based Employment

Programs (question 43c)

$0

Student's Grant and Scholarship Aid Reported in AGI (question

43d)

$0

Student's Taxable Combat Pay Reported in AGI (question 43e)

$0

Student's Cooperative Education Earnings (question 43f)

$0

Student's Payments to Tax-Deferred Pensions & Savings

(question 44a)

$0

Student's Deductible Payments to IRA/Keogh/Other (question

44b)

$0

Student's Child Support Received (question 44c)

$0

Student's Tax Exempt Interest Income (question 44d)

$0

Student's Untaxed Portions of IRA Distributions (question 44e)

$0

Student's Untaxed Portions of Pensions (question 44f)

$0

Student's Housing, Food, & Living Allowances (question 44g)

$0

Student's Veterans Noneducation Benefits (question 44h)

$0

Student's Other Untaxed Income or Benefits (question 44i)

$0

Money Received or Paid on Student's Behalf (question 44j)

$0

Skip Student's Asset Questions?

YES

Student's Total of Cash, Savings, and Checking Accounts

(question 40)
Student's Net Worth of Current Investments (question 41)
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Student's Net Worth of Businesses/Investment Farms (question

42)

Sign & Submit

Sign & Submit
Preparer's Social Security Number (question 104)
Preparer's Employer Identification Number (EIN) (question 105)

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