Office of Scholarships and Financial Aid Box 7302, 2016 Harris Hall Raleigh, NC 27695-7302 Phone: (919) 515-2421

Fax: (919) 515-8422

Please provide a response to every question indicating the amount received during the 2008 calendar year. Enter zeros if no funds were received. Student Name: Student & Spouse (if married) $ Student ID#: Parent(s)/ (StepParent) $

Additional Financial Information

Child Support you paid because of divorce or separation or as a result of legal requirement. (Don't include
support you receive for children in your household).

Please list the name(s) for whom child support is paid: ________________________________________ ____________________________________________________________________________________ Earnings you reported on your tax return from need-based employment programs, such as Federal WorkStudy and need-based employment portions of fellowships and assistantships. Grant and scholarship aid you reported on your tax return included in your adjusted gross income. (Includes
Americorps 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 your adjusted gross income. Do not enter untaxed combat pay reported on the W-2 in box 12, Code Q)

$ $ $

$ $ $

2008 Untaxed Income $ $ $ $ $ $ $ $ $

Payments you made to tax-deferred pension and savings plans (paid directly or withheld from earnings), including, but not limited to, amounts reported on W-2 forms in Boxes 12a through 12d, codes D,E,F,G,H & S. Child Support you received for all children. Don't include foster care or adoption payments. Housing, food, or other living expenses paid to the members of the military, clergy, or others (including cash payments and cash value of benefits). Veterans noneducation benefits such as Disability, Death Pension, or Dependency & Indemnity Compensation (DIC) and/or VA Educational Work-Study allowances Other untaxed income not already reported, such as workers' compensation, disability, etc. Don't include
student aid, earned income credit, child tax credit, welfare payments, untaxed social security benefits, Supplemental Security Income, Workforce Investment Act educational benefits, combat pay, benefits from flexible spending arrangements (e.g. cafeteria plans), foreign income exclusion or credit for federal tax on special fuels.

$ $ $ $ $ N/A $ $ $

Money received, or paid on your behalf (e.g. bills), not reported elsewhere on this form

Confirmation of Assets/Investment Values

As of the date you submitted your FAFSA, what was the total current balance of cash, savings and checking accounts? As of the date you submitted your FAFSA, what was the net worth of your investments, including real estate? You should exclude the value of the primary home you live in. (Net worth means value minus
debt.)

As of the date you submitted your FAFSA, what is the net worth of your current businesses and/or investment farms? (Do not include a farm that you live on and operate or a business with 100 or fewer full-time
employees.)

In 2007 or 2008, did you, your parents or anyone in your parents household receive benefits from any of the federal benefits programs listed below? Please mark all the programs that apply. Supplemental Security Income Food Stamps Free or Reduced Price Lunch TANF WIC

Each person signing this form certifies that all the information reported on it is complete and correct. If a dependent student, at least one parent must sign. Warning: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.

Student's Signature

________ Date

Parents Signature (Dependent Students Only)

___________ Date