Work Sheet A

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Student’s Name ______________________________ SSN# ________________________ FAFSA’s 2007-2008 Worksheet A, B, C Worksheet A (Calendar Year 2006) Student/Spouse Parent(s) $_____________ Earned income credit from IRS Form 1040-line 65a; 1040A-line 41a; 1040EZ-line 8a; or Telefile-line L. $______________ $____________ $ ___________ Additional child tax credit from IRS Form 1040-line 67 or 1040-line 42 $ _____________ Welfare benefits, including Temporary Assistance for Needy Families (TANF). Don’t include food stamps or subsidized housing.. $_____________ Social Security benefits received, for all household members reported in question 84 (or 65 fro your parent(s) , that were not taxed (such as SSI). $______________ $______________ Worksheet (Calendar Year 2006) $___________ Payments t tax-deferred pension and savings plans (paid directly or withheld form earnings), including, but not limited to, amounts reported on the W-2 Form in Boxes 12a -12d, codes D,E,F,G,H, and S $_____________ IRA deductions and payments to self-employed SEP, SIMPLE, and Keogh and other qualified plans from IRS Form 1040 –total if lines 25 + 32 or 1040A-line 17. $___________ $_____________ $_____________ $_____________ $____________ $___________ Child support received for all children. Do not include foster care or adoption payments. $___________ $___________ $___________ Tax exempt interest income from IRS Form 1040-line 8b or 1040A-line 8b Foreign income exclusion form IRS Form 2555-line 43 or 2555EZ –line 18 Untaxed portions of IRA distributions from IRS Form 1040 lines (15a minus 15b) or 1040A- lines (11a minus 11b) Exclude rollovers. If negative, enter a zero here. $_______________ Untaxed portions of pensions from IRS Form 1040-lines (16a minus 16b) or 1040A –lines (12a minus 12b) Exclude rollovers. If negative, enter a zero here. $____________ ***NOTE*** Please enter the amount of above distribution that was Rolled Over $ __________ $____________ $____________ Credit for federal tax on special fuels form IRS Form 4136-line 10- non-farmers only. Housing, food, and other living allowances paid to members of the military, clergy, and others (Including cash payments and cash value of benefits) $_______________ $_______________ $_______________ Veterans’ noneducation benefits such as Disability, Death pensions, or Dependency $ Indemnity $_____________ compensation (DIC) and /or VA Educational Work- Study Allowances Any other untaxed income or benefits not reported elsewhere on Worksheets A and B, such as Workers compensation, untaxed portions of railroad retirement benefits, Black Lung Benefits, Disability, etc. Don’t include student aid, Workforce Investment Act educational benefits, $_____________ or benefits from flexible spending arrangement, e.g. cafeteria plans. $_____________ Money received, or paid on your behalf (e.g., bills), not reported elsewhere on this form. $_______________ $______________ $______________ Worksheet C (Calendar Year 2006) $_____________ Education credits (Hope & lifetime Learning tax credits) from IRS Form 1040-line 49 or 1040A-line 31 Child Support paid because of divorce or separation or as a result of a legal requirement. Do not include support for children listed in your (or your parents) household as reported in Ques. 84 or 65. $_____________ $ _____________ $_____________ Taxable earnings form need-based employment programs, such as Federal Work-Study and need – $_______________ Based employment portions of fellowships and assistantships. Student grant and scholarship aid reported to the IRS in your (or your parents) adjusted gross income, Includes AmeriCorps benefits (awards, living allowances and interest accrual payments), as well as $_______________ grant or scholarship portions of Fellowships and assistantships. $______________ $______________ Student’s Signature:___________________________________________________________ Date: _________________________ Parents Signature ( or step- Parent’s) (if dependent student ): ________________________________________________________

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