Electronic SAR

Free Application for Federal Student Aid (FAFSA)

FAFSA 2011-2012 Electronic SAR (IC19)

Federal Student Aid Application

OMB: 1845-0001

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1845-0001 can be found here:

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2011-2012

Electronic Student Aid Report (SAR)

The SAR summarizes the information you submitted on your 2011-2012 Free Application for Federal Student Aid (FAFSA).
Application Receipt Date:
Processed Date:

01/01/2011
01/17/2011

XXX-XX-1239 DE 01
EFC: C
DRN: 5517

Comments About Your Information

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There are issues with your FAFSA information that need to be resolved before your eligibility can be determined. Be sure to review the items marked with a 'h' and
make any corrections if necessary by selecting the 'Make Corrections' button at the bottom of the page.

Your citizenship status has been confirmed by the Department of Homeland Security and you meet the citizenship requirements for federal student aid.

WHAT YOU MUST DO NOW (Use the checklist below to make sure that all of your issues are resolved.)

Contact the following agency(ies) regarding your defaulted or fraudulent federal student loan(s):

Debt Collection Service, 1-800-621-3115 (GA 739)

Oklahoma Guaranteed Student Loan Program, Collection Office, 1-800-522-8022 or 405-234-4300 (GA 740)

Oregon Student Assistance Commission, Collection Office, 541-984-2450 or 1-888-323-3262 (GA 741)

Pennsylvania Higher Education Assistance Agency, 1-800-233-0751 or 1-800-692-7392 (GA 742)

The National Student Loan Data System (NSLDS) indicates that one or more of your federal student loans have been discharged. If you have questions, contact
the financial aid office at your school.

You reported that your parents will not file an income tax return, but the amount you reported for your parents' income appears to be over the minimum amount
required to file a tax return. Please review Items 79, 86, and 87 and make the necessary corrections by selecting the 'Make Corrections' button at the bottom of
the page.

If you need to make corrections to your information, select the 'Make Corrections' button at the bottom of the page. You must use your Federal Student Aid PIN to
access your record online. If you need additional help with your SAR, contact your school's financial aid office or the Federal Student Aid Information Center at 1800-4-FED-AID (1-800-433-3243). If your mailing address or e-mail address changes, you can make the correction online or call 1-800-4-FED-AID and ask a
customer service representative to make the change for you.

Page 1

FAFSA Data
Assumed fields, based on the data you entered, are marked with an ‘*’ (asterisk) sign.
1. Student’s Last Name:

DEPENDENT

2. Student’s First Name:

DFAFSA19

3. Student’s Middle Initial:

4. Student's Permanent Mailing Address:

101 MAIN STREET

5. Student's Permanent City:

CITY

6. Student's Permanent State:

7. Student's Permanent ZIP Code:

21060

8. Student's Social Security Number:

XXX-XX-1239

9. Student's Date of Birth:

11/10/1990

10. Student's Permanent Home Phone Number:

(202) 555-1212

11. Student's Driver's License Number:
12. Student's Driver's License State:

[email protected]

14. Student's Citizenship Status:

NO, BUT I AM AN ELIGIBLE NONCITIZEN

15. Student's Alien Registration Number:

A123456790

16. Student's Marital Status:

I AM SINGLE

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17. Student’s Marital Status Date:

13. Student's E-mail Address:

18. Student's State of Legal Residence:

19. Was Student a Legal Resident Before January 1, 2006?
20. Student’s Legal Residence Date:

MALE

21. Is the Student Male or Female?
22. Register Student With Selective Service?

ELIGIBLE FOR AID

23. Drug Conviction Affecting Eligibility?
24. Father's Educational Level:

HIGH SCHOOL

MIDDLE SCHOOL/JR. HIGH

25. Mother's Educational Level:

GED CERTIFICATE

26. High School or Equivalent Completed?
27a. Student’s High School Name:

27b. Student’s High School City:
27c. Student’s High School State:

28. First Bachelor's Degree by July 1, 2011?

3RD YR./JUNIOR

29. Student's Grade Level in College in 2011-2012:

CERTIFICATE/DIPLOMA (OCCUPATIONAL/TECHNICAL/EDUCATION PROGRAM OF AT LEAST 2 YR.)

30. Type of Degree/Certificate:

YES

31. Interested in Work-study?
32. Student Filed 2010 Income Tax Return?

34. Student Eligible to File a 1040A or 1040EZ?
35. Student's 2010 Adjusted Gross Income:
36. Student's 2010 U.S. Income Tax Paid:

37. Student's 2010 Exemptions Claimed:

ALREADY COMPLETED

33. Student's Type of 2010 Tax Form Used:

38. Student's 2010 Income Earned from Work:

IRS 1040

$1,000
$0
0
$1,000

39. Spouse's 2010 Income Earned from Work:

40. Student's Total of Cash, Savings, and Checking Accounts:

$2,000

41. Student's Net Worth of Current Investments:

42. Student's Net Worth of Businesses/Investment Farms:

43a. Student's Education Credits:

43b. Student's Child Support Paid:

43c. Student's Taxable Earnings from Need-Based Employment Programs:

43d. Student's Grant and Scholarship Aid Reported in AGI:

43e. Student's Taxable Combat Pay Reported in AGI:

43f. Student's Cooperative Education Earnings:

44a. Student's Payments to Tax-Deferred Pensions & Savings:

44b. Student's Deductible Payments to IRA/Keogh/Other:

44c. Student's Child Support Received:

44d. Student's Tax Exempt Interest Income:

44e. Student's Untaxed Portions of IRA Distributions:

44f. Student's Untaxed Portions of Pensions:

44g. Student's Housing, Food, & Living Allowances:

44h. Student's Veterans Noneducation Benefits:

44i. Student's Other Untaxed Income or Benefits:

44j. Money Received or Paid on Student’s Behalf:

45. Student Born Before January 1, 1988?

46. Is Student Married?

47. Working on Master’s or Doctorate in 2011-2012?

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

49. Is Student a Veteran?

50. Does Student Have Children He/She Supports?

51. Does Student Have Dependents Other than Children/Spouse?

52. Parents Deceased?/Student Ward of Court?/In Foster Care?

53. Is or Was Student an Emancipated Minor?

54. Is or Was Student in Legal Guardianship?

55. Is Student an Unaccompanied Homeless Youth as Determined by High School/Homeless Liaison?

56. Is Student an Unaccompanied Homeless Youth as Determined by HUD?

57. Is Student At Risk of Homelessness?

58. Parents' Marital Status:

WIDOWED

59. Parents’ Marital Status Date:

02/2003

60. Father’s/Stepfather’s Social Security Number:
61. Father's/Stepfather's Last Name:

Page 2

62. Father's/Stepfather's First Name Initial:
63. Father’s/Stepfather’s Date of Birth:
64. Mother’s/Stepmother’s Social Security Number:

XXX-XX-1111

65. Mother's/Stepmother's Last Name:

PARENT

66. Mother's/Stepmother's First Name Initial:

67. Mother’s/Stepmother’s Date of Birth:

12/31/1945

68. Parents' E-mail Address:
69. Parents' State of Legal Residence:

70. Were Parents Legal Residents Before January 1, 2006?

71. Parents’ Legal Residence Date:

12/2007

72. Parents' Number of Family Members in 2011-2012:

73. Parents' Number in College in 2011-2012 (Parents Excluded):

74. Parents Received Supplemental Security Income?
75. Parents Received Food Stamps?
76. Parents Received Free/Reduced Price Lunch?
77. Parents Received TANF?
78. Parents Received WIC?
79. Parents Filed 2010 Income Tax Return?

NOT GOING TO FILE h

80. Parents' Type of 2010 Tax Form Used:

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81. Parents Eligible to File a 1040A or 1040EZ?

82. Is Parent a Dislocated Worker?
83. Parents' 2010 Adjusted Gross Income:
84. Parents' 2010 U.S. Income Tax Paid:
85. Parents' 2010 Exemptions Claimed:

(BLANK) DATA IS REQUIRED h

86. Father's/Stepfather's 2010 Income Earned from Work:
87. Mother's/Stepmother's 2010 Income Earned from Work:

$50,000 h
$10,000

88. Parents' Total of Cash, Savings, and Checking Accounts:

$20,000

89. Parents' Net Worth of Current Investments:

$5,000

90. Parents' Net Worth of Businesses/Investment Farms:

91a. Parents’ Education Credits:
91b. Parents’ Child Support Paid:

$0
$0

91c. Parents' Taxable Earnings from Need-Based Employment Programs:

91d. Parents' Grant and Scholarship Aid Reported in AGI:

91f. Parents’ Cooperative Education Earnings:
92a. Parents' Payments to Tax-Deferred Pensions & Savings:

92c. Parents’ Child Support Received:
92d. Parents’ Tax Exempt Interest Income:
92e. Parents’ Untaxed Portions of IRA Distributions:
92f. Parents’ Untaxed Portions of Pensions:
92g. Parents’ Housing, Food, & Living Allowances:

92h. Parents' Veterans Noneducation Benefits:

92i. Parents’ Other Untaxed Income or Benefits:

$0
$0

92b. Parents' Deductible Payments to IRA/Keogh/Other:

91e. Parents' Taxable Combat Pay Reported in AGI:

$0
$0
$0
$0
$0
$0

93. Student's Number of Family Members in 2011-2012:
94. Student's Number in College in 2011-2012:

95. Student Received Supplemental Security Income?
96. Student Received Food Stamps?

97. Student Received Free/Reduced Price Lunch?
98. Student Received TANF?
99. Student Received WIC?
100. Is Student or Spouse a Dislocated Worker?
101a. First Federal School Code:

001002

101b. First Housing Plans:

ON CAMPUS

101c. Second Federal School Code:
101d. Second Housing Plans:
101e. Third Federal School Code:
101f. Third Housing Plans:
101g. Fourth Federal School Code:
101h. Fourth Housing Plans:
101i. Fifth Federal School Code:
101j. Fifth Housing Plans:
101k. Sixth Federal School Code:
101l. Sixth Housing Plans:
101m. Seventh Federal School Code:
101n. Seventh Housing Plans:
101o. Eighth Federal School Code:
101p. Eighth Housing Plans:
101q. Ninth Federal School Code:
101r. Ninth Housing Plans:
101s. Tenth Federal School Code:
101t. Tenth Housing Plans:
102. Date Completed:

08/11/0102

103. Signed By:

104. Preparer’s Social Security Number:
105. Preparer’s Employer Identification Number (EIN):
106. Preparer’s Signature:

Page 3

Graduation/Retention/Transfer Rates
College Rates
The table shows the graduation, retention, and transfer rates for the schools you selected. Go to the College Navigator Web site at
www.nces.ed.gov/collegenavigator for complete information.

Graduation Rate
29%

Retention Rate
69%

Transfer Rate
N/A

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School Name
ALABAMA AGRCLTL & MECHL
UNIV

Page 4

Your Financial Aid History Information
The information below is the total amount of student loans that you owe. These loans are administered by the U.S. Department of Education (ED). You
should confirm that these loan totals are correct. You can use your Federal Student Aid PIN to view details on the individual loans that make up these totals at
the National Student Loan Data System (NSLDS) Web site at www.nslds.ed.gov. For more information about your PIN, go to www.pin.ed.gov. If you feel that
the amounts listed on this page are incorrect, or you have other questions related to a loan, you should contact the loan servicer indicated on the NSLDS Web
site. You can obtain general information about each of the types of loans that are listed below by visiting our studentaid.ed.gov Web site.
Note that the ‘Subsidized’ and ‘Unsubsidized’ amounts include the appropriate portions of any Consolidation Loans you may have. If there is an amount listed
for ‘Unallocated Consolidation Loans’ it is because we could not determine whether those balances were subsidized or unsubsidized.
Remember you are responsible for repaying all of the amounts that you borrow, plus interest. As a general rule, with an assumed interest rate of 5%, the
monthly payment amount over a ten-year repayment period would be approximately $10.61 for every $1,000 that you borrowed. Of course your actual
repayment amount will depend upon how much you borrow, the interest rate when you enter repayment, and how long your repayment term is.
Total Amount of Loans Outstanding Total Principal
Balance

Unsubsidized Loans:

N/A

Combined Loans:

N/A

Unallocated Consolidation Loans:

$3,239

N/A

Federal Perkins Loan Amounts:
Total Outstanding Principal Balance:

$777,777

N/A

$8,888

N/A

$999,999

TEACH Grants Converted to Direct
Loans:

$5,479

2011-2012 Loan Amount:

Unsubsidized Loans:

Total

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N/A

Subsidized Loans:

Remaining Amount to be
Disbursed

FFEL (Bank Loans) and/or Direct
Loans:

At this point, the school(s) listed on your application have access to your information. The school(s) may put together or change an aid package based on
your Expected Family Contribution and notify you.

The amount of aid you receive from a school will depend on the cost of attendance at that school, your enrollment status (full-time, three-quarter-time, halftime, or less than half-time), Congressional appropriations, and other factors. Review your financial aid notification from the school(s) or contact the Financial
Aid Administrator at the school(s).
Note: Your school has the authority to request copies of certain financial documents to verify information you reported on your application.
The Office of Management and Budget Wants You To Know:
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 1845-0008. The time required to complete this information collection is estimated to
be an average of 10 to 34 minutes, including the time to review instructions, search existing data sources, gather the data needed, and complete and review
the information collected. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, write to: U.S.
Department of Education, Washington, DC 20202-4651. If you have any comments or concerns regarding the status of your individual submission of this
form, write directly to: Federal Student Aid Information Center, P.O. Box 84, Washington, DC 20044.
By answering questions 101a through 101t, and signing the Free Application for Federal Student Aid, you give permission to the U.S. Department of Education
to provide information from your application to the college(s) you entered. You also agree that such information is deemed to incorporate by reference the
certification statement on the sign and submit page of the financial aid application. The certification statement can be viewed at
www.fafsa.gov/help/ffinal02a.htm.
To protect the confidentiality of your application data, you should never give, share or disclose your Federal Student Aid PIN with anyone, including
commercial service providers that provide assistance with the financial aid process. You should keep your PIN in a safe location. If you think your PIN has
been compromised, go to Federal Student Aid's PIN Web site at www.pin.ed.gov and change your PIN.
WARNING: If you are convicted of drug distribution or possession for an offense that occurred while you were receiving Title IV aid, your eligibility for Title IV
student financial aid is subject to suspension or termination. If your drug conviction status changes at any time during the 2011-2012 award year, you must
update your answer to the drug conviction affecting eligibility question.

Page 5

File Type	application/pdf
File Modified	2010-11-10
File Created	2010-11-10