# STUDENT AID REPORT ACKNOWLEDGEMENT

Dear Your Student Aid Report (SAR) Acknowledgement summarizes the information you submitted on your 2015-2016 Free Application for Federal Student Aid (FAFSA). Application Status (review the checked boxes)

Federal Student Aid Eligibility (review the checked boxes)

You should keep this SAR Acknowledgement for your records!
PAGE 1 OF 3 WWW.FAFSA.GOV OMB No. 1845-0001 DATA RELEASE NUMBER (DRN): 

# 2015-2016

The EFC isnot the amount of money that your family must provide. Rather, you should think of the EFC as an index that colleges use to determine how much financial aid you would receive if you were to attend their school. Financial aid may include grants (free funds that do not have to be repaid), low-interest loans (borrowed funds that must be repaid), and/or work-study (paid part-time employment). This award information will vary from college to college because the cost of attending each is different. Please note that your EFC is subject to change if you update or correct your FAFSA. For more information about the EFC and other sources of aid, go to StudentAid.gov.

You should keep this SAR Acknowledgement for your records! AUGUST 21, 2015 000117C041 JOHN SMITH 742 EVERGREEN TERRACE SPRINGFIELD OH 55555 2245 EXPECTED FAMILY CONTRIBUTION (EFC): 000000 C

Your FAFSA appears to be complete.Review the data on page 2 and 3. We may have assumed certain information to calculate your eligibility for federal student aid. We printed any assumptions we made and the word "assumed" for the items on the back of this page. If you need to make corrections, you can go to www.fafsa.gov to access your information or you can contact the financial aid office at one of the schools you listed on your application for assistance. The school(s) listed on your FAFSA will receive your information.

999999C999 01234567891SM01 

### JOHN SMITH,

The data submitted on your FAFSA is used to calculate your Expected Family Contribution (EFC), which is 000000. 

## ) F 211 1516



## ) We sent your information to other federal agencies through computer matching programs to verify your eligibility for federal student aid and there appears to be an issue with the information provided on your application. You can review information about these issues by going to www.fafsa.gov and selecting Student Aid Report (SAR). You must work with your financial aid office to resolve any data matching issues before we can determine if you are eligible to receive federal student aid. 

## ) Unless you are completing the verification process, it may be too late for you to make corrections or give us any more information this year. If you are completing verification and you need to correct your information, contact the FAA at your school for assistance. We must have your corrections no later than September 17, 2016. 

## ) Based on your EFC it appears thatyou may be eligible for a Federal Pell Grant of up to $5730, provided you have not met or exceeded the lifetime limit established for the Federal Pell Grant program. You may also be eligible for other grants, low-interest student loans, and work-study opportunities. Your Financial Aid Administrator (FAA) will determine what types of aid and how much you are eligible to receive.20. DATE YOU BECAME A LEGAL RESIDENT This section contains information from your student aid application (shaded items display parents' information, if provided). If you need to make corrections, visit www.fafsa.gov or contact the financial aid office at your college.

1. LAST NAME 2. FIRST NAME 3. MIDDLE INITIAL 4. ADDRESS 5. CITY 6. STATE ABBREVIATION 7. ZIP CODE 8. SOCIAL SECURITY NUMBER 9. DATE OF BIRTH 10. PERMANENT PHONE NUMBER 11. DRIVER'S LICENSE NUMBER 12. DRIVER'S LICENSE STATE ABBREVIATION 13. ST E-MAIL 14. CITIZENSHIP STATUS 15. ALIEN REGISTRATION NUMBER 16. MARITAL STATUS 17. DATE OF MARITAL STATUS 18. STATE OF LEGAL RESIDENCE ABBREVIATION 19. LEGAL RESIDENT BEFORE JANUARY 1, 2010?

21. ARE YOU MALE OR FEMALE? 22. REGISTER YOU FOR SELECTIVE SERVICE? 23. DRUG CONVICTION AFFECTING ELIGIBILITY?

30. TYPE OF DEGREE/CERTIFICATE 29. GRADE LEVEL IN COLLEGE IN 2015-2016

31. INTERESTED IN WORK-STUDY? 32. FILED 2014 INCOME TAX RETURN 33. TYPE OF 2014 TAX FORM USED

35. ELIGIBLE TO FILE 1040A OR 1040EZ? 36. ADJUSTED GROSS INCOME FROM IRS FORM 37. U.S. INCOME TAX PAID 38. EXEMPTIONS CLAIMED 39. STUDENT'S INCOME EARNED FROM WORK 40. SPOUSE'S INCOME EARNED FROM WORK 41. CASH, SAVINGS, AND CHECKING 42. NET WORTH OF INVESTMENTS 43. NET WORTH OF BUSINESS/INVESTMENT FARMS 44. STUDENT'S ADDITIONAL FINANCIAL INFORMATION a) EDUCATION CREDITS b) CHILD SUPPORT PAID c) TAXABLE EARNINGS NEED-BASED EMPLOYMENT d) STUDENT GRANT AND SCHOLARSHIP AID REPORTED e) COMBAT PAY/SPECIAL COMBAT PAY

45. STUDENT'S UNTAXED INCOME a) TAX-DEFERRED PENSION/SAVINGS b) IRA DEDUCTIONS AND PAYMENTS c) CHILD SUPPORT RECEIVED d) TAX-EXEMPT INTEREST INCOME e) UNTAXED IRA DISTRIBUTIONS f) UNTAXED PORTIONS OF PENSIONS g) MILITARY OR CLERGY ALLOWANCES h) VETERANS NONEDUCATION BENEFITS i) OTHER UNTAXED INCOME j) MONEY RECEIVED OR PAID ON YOUR BEHALF 46. BORN BEFORE 1-1-1992?

48. WORKING ON MASTER'S OR DOCTORATE? 47. ARE YOU MARRIED?

51. HAVE CHILDREN YOU SUPPORT? 52. DEPENDENTS OTHER THAN CHILDREN/SPOUSE? 53. PARENTS DECEASED, FOSTER CARE, WARD OF COURT? 49. ON ACTIVE DUTY IN U.S. ARMED FORCES? 50. VETERAN OF U.S. ARMED FORCES?

54. ARE/WERE AN EMANCIPATED MINOR? 55. ARE/WERE IN LEGAL GUARDIANSHIP? 56. VERIFIED AS A HOMELESS YOUTH?

58. VERIFIED AS UNACCOMPANIED YOUTH AT RISK FOR HOMELESS?



### PAGE 2 OF 3 $ $

$ $ $ $ $
$ $ $ $ $

$ $ $

$ $ $

$ $ $

$

57. DETERMINED BY DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT THAT YOU WERE HOMELESS? 24. PARENT 1 EDUCATIONAL LEVEL 25. PARENT 2 EDUCATIONAL LEVEL 26. HIGH SCHOOL COMPLETION STATUS?

28. FIRST BACHELOR'S DEGREE BY 7-1-2015?

60. PARENTS' MARITAL STATUS DATE 61. PARENT 1 SOCIAL SECURITY NUMBER 62. PARENT 1 LAST NAME 63. PARENT 1 FIRST INITIAL 64. PARENT 1 DATE OF BIRTH 65. PARENT 2 SOCIAL SECURITY NUMBER 66. PARENT 2 LAST NAME f) COOPERATIVE EDUCATION PROGRAM EARNINGS $

27.a HS NAME 27.b HS CITY 27.c HS STATE SMITH JOHN

12344 ABCDEFGHIJKLMNOPQRSTUVWXYZABC ABCDEFGHIJKLMNOP AB 12345 XXX-XX-1234 JANUARY 30, 1992 (999)999-9999 A-1234-446-789-012-3 AB
(ELIG NONCIT ASSUMED) A123446789 (MARRIED ASSUMED) JANUARY 2005 AB

JANUARY 2012 MALE REGISTER ME ELIGIBLE FOR AID COLLEGE COLLEGE GED/STATE EQUIVALENT TEST

1ST BA 1ST PREV ATTENDED

YES WILL FILE U.S. TRUST TERRITORY

YES (-1,123,446 ASSUMED) (0 ASSUMED)
(1,123,446 ASSUMED) (1,123,446 ASSUMED) 1,123,446 1,123,446 00 YES PRINCE GEORGE'S COUNTY HIGH SCHOOL BELTSVILLE MD 1,123,446

YES

YES YES

YES YES YES YES YES

YES YES YES

YES YES

DECEMBER 1990 XXX-XX-1234 ABCDEFGHIJKLMNOP X JANUARY 23, 1973 XXX-XX-1234 ABCDEFGHIJKLMNOP



### 999999C999 01234567891SM01 67. PARENT 2 FIRST INITIAL 68. PARENT 2 DATE OF BIRTH 69. PAR EMAIL CHRISTOPHER.E.STUDENTS.MOTHER@HOME.COMCAST.COM 70. PARENTS' STATE OF LEGAL RESIDENCE JANUARY 24, 1972 D

AB 34. TAX RETURN FILING STATUS 2014 MARRIED-FILED SEPARATE RETURN 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446

1,123,446 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446 1,123,446

71. LEGAL RESIDENT BEFORE JANUARY 1, 2010? 72. DATE PARENT BECAME LEGAL RESIDENT DECEMBER 2012 UNMARRIED AND BOTH PARENTS LIVING TOGETHER 59. PARENTS' MARITAL STATUS NO

NO100. RECEIVED TANF? 101. RECEIVED WIC? 102. STUDENT OR SPOUSE A DISLOCATED WORKER?

104. DATE COMPLETED 105. SIGNED BY 106. PREPARER'S SOCIAL SECURITY NUMBER 107. PREPARER'S EIN 108. PREPARER'S SIGNATURE



### PAGE 3 OF 3 $ 103.a FIRST COLLEGE NAME

103.b FIRST HOUSING PLAN 103.c SECOND COLLEGE NAME

103.d SECOND HOUSING PLAN 103.e THIRD COLLEGE NAME

103.f THIRD HOUSING PLAN 103.g FOURTH COLLEGE NAME

103.h FOURTH HOUSING PLAN $ 79. RECEIVED WIC? 80. PARENT(S) FILED 2014 TAX RETURN 81. TYPE OF 2014 TAX FORM USED

83. ELIGIBLE TO FILE A 1040A OR 1040EZ? 84. EITHER OF PARENTS A DISLOCATED WORKER? 85. ADJUSTED GROSS INCOME FROM IRS FORM 86. U.S. INCOME TAX PAID 87. EXEMPTIONS CLAIMED 88. PARENT 1 INCOME EARNED FROM WORK 89. PARENT 2 INCOME EARNED FROM WORK 90. CASH, SAVINGS, AND CHECKING 91. NET WORTH OF INVESTMENTS 92. NET WORTH OF BUSINESS/INVESTMENT FARMS 93. PARENTS' ADDITIONAL FINANCIAL INFORMATION a) EDUCATION CREDITS b) CHILD SUPPORT PAID c) TAXABLE EARNINGS NEED-BASED EMPLOYMENT d) STUDENT GRANT AND SCHOLARSHIP AID REPORTED e) COMBAT PAY/SPECIAL COMBAT PAY $ $
$ $ $ $ $
$ $ $ $ $ 73. NUMBER OF FAMILY MEMBERS IN 2015-2016 74. NUMBER IN COLLEGE IN 2015-2016 75. PARENT RECEIVED SSI? 76. RECEIVED SNAP? 77. RECEIVED FREE/REDUCED PRICE LUNCH? 78. RECEIVED TANF?

f) COOPERATIVE EDUCATION PROGRAM EARNINGS $

b) IRA DEDUCTIONS AND PAYMENTS c) CHILD SUPPORT RECEIVED d) TAX-EXEMPT INTEREST INCOME e) UNTAXED IRA DISTRIBUTIONS f) UNTAXED PORTIONS OF PENSIONS g) MILITARY OR CLERGY ALLOWANCES h) VETERANS NONEDUCATION BENEFITS i) OTHER UNTAXED INCOME 95. NUMBER OF FAMILY MEMBERS IN 2015-2016 96. NUMBER IN COLLEGE IN 2015-2016 97. STUDENT RECEIVED SSI? 98. RECEIVED SNAP? 99. RECEIVED FREE/REDUCED PRICE LUNCH?

$ $ $ $ $ $ $ $ 94. PARENTS' UNTAXED INCOME a) TAX-DEFERRED PENSION/SAVINGS $



### For Financial Aid Office Use Only Transaction Source: Verification Flag: SAR C Flag: Application Receipt Date: Transaction Process Date: Transaction Receipt Date: SSN Match Flag: Expected Family Contribution: Primary Secondary Automatic Zero EFC Flag: Dependency Status: Formula Type: Simplified Needs Test Flag: Professional Judgment: Dependency Override: Hold Code: Pell Eligible Flag: Duplicate SSN Flag:

DHS Match Flag: DHS Sec. Conf. Flag: NSLDS Match Flag: Selective Service Registration Flag: DHS Verification #: VA Match Flag: NSLDS Results Flag: NSLDS Transaction Number: Selective Service Match: SSA Citizenship Code: P1SSN Match Flag: P2SSN Match Flag: Special Circumstances: IRS Request Flag: Student: Parent: High School Flag: THE PENNSYLVANIA STATE UNIVERSITY NEW KENSINGTON CAMPUS COMMON

VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY

UNIVERSITY OF MARYLAND COLLEGE PARK

UNIVERSITY OF MASSACHUSETTS AMHERST

Your FAFSA information was sent to all the colleges you listed although they are not all shown here. To see all of the colleges you listed, go to www.fafsa.gov and select "Student Aid Report (SAR)". YES YES WILL FILE U.S. TRUST TERRITORY

YES (-1,123,456 ASSUMED) (0 ASSUMED) 03 (1,123,456 ASSUMED) (1,123,456 ASSUMED) 1,123,456 1,123,456 1,123,456 03 2 YES YES YES YES

1,112,345

NOVEMBER 23, 2015 STUDENT REPORTED REPORTED SIGNED NO NO NO NO

NO

ON CAMPUS

OFF CAMPUS

ON CAMPUS

OFF CAMPUS



### 999999C999 01234567891SM01 4A Y Y 04/21/2015 04/21/2015 04/21/2015
4 4 8 2 000000 000000 Y 2 Y

N N 1 1 999999999999999 Y X

Y N

A 4 8 1 Y

Reject Code(s): 01 02 03 04 05 06 07 Comment Codes: 001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 016 017 018 019 020 1,112,345 1,112,345 1,112,345 1,112,345 1,112,345

1,112,345 1,112,345 1,112,345 1,112,345 1,112,345 1,112,345 1,112,345 1,112,345 1,112,345

NSLDS Unusual Enrollment History Flag: 1 82. TAX RETURN FILING STATUS 2014 MARRIED-FILED SEPARATE RETURN

IRS Display Flag: Student: Parent: 01 01 A C