2020-2021 Student Aid Report Acknowledgement (SAR ACK)

STUDENT AID REPORT
ACKNOWLEDGEMENT
2020-2021
OMB No. 1845-0001
DATA RELEASE NUMBER (DRN): 2245
EXPECTED FAMILY CONTRIBUTION (EFC): 000000 C

19

F 211 2021

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HTTPS://FAFSA.GOV
NOVEMBER 23, 2020
000117C041
JOHN SMITH
742 EVERGREEN TERRACE
SPRINGFIELD OH 55555

Dear

JOHN SMITH,

Your Student Aid Report (SAR) Acknowledgement summarizes the information you submitted on your 2020-2021
Free Application for Federal Student Aid (FAFSA).
Application Status (review the checked boxes)
) Your FAFSA appears to be complete. Review the data on pages 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 https://fafsa.gov and use your FSA ID
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.

Federal Student Aid Eligibility (review the checked boxes)

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

The EFC is not 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), work-study (paid part-time employment), and/or low-interest
loans (borrowed funds that must be repaid). 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.
) Based on your EFC it appears that you may be eligible for a Federal Pell Grant of up to $6195, 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, work-study opportunities, and low-interest student loans. Your Financial Aid Administrator (FAA) will determine
what types of aid and how much you are eligible to receive.
) 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 https://fafsa.gov and selecting “View or Print your Student Aid
Report (SAR)” after logging in. 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
Financial Aid Administrator (FAA) at your school for assistance. We must have your corrections no later than September
11, 2021.
You should keep this SAR Acknowledgement for your records!
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This section contains information from your student aid application (shaded items display parents' information, if provided). If you need to make
corrections, visit https://fafsa.gov or contact the financial aid office at your college.

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$ 1,123,446
42. NET WORTH OF BUSINESS/INVESTMENT FARMS
43. STUDENT'S ADDITIONAL FINANCIAL INFORMATION
a) EDUCATION CREDITS
$ 1,123,446
$ 1,123,446
b) CHILD SUPPORT PAID
c) TAXABLE EARNINGS NEED-BASED EMPLOYMENT
$ 1,123,446
d) COLLEGE GRANT AND SCHOLARSHIP AID REPORTED $ 1,123,446
$ 1,123,446
e) COMBAT PAY/SPECIAL COMBAT PAY
f) COOPERATIVE EDUCATION PROGRAM EARNINGS $ 1,123,446
44. STUDENT'S UNTAXED INCOME
$ 1,123,446
a) TAX-DEFERRED PENSIONS/SAVINGS
$ 1,123,446
b) IRA DEDUCTIONS AND PAYMENTS
$ 1,123,446
c) CHILD SUPPORT RECEIVED
$ 1,123,446
d) TAX-EXEMPT INTEREST INCOME
e) UNTAXED PORTIONS OF IRA DISTRIBUTIONS/PENSIONS $ 1,123,446
$ 1,123,446
f) MILITARY OR CLERGY ALLOWANCES
$ 1,123,446
g) VETERANS NONEDUCATION BENEFITS
$ 1,123,446
h) OTHER UNTAXED INCOME
$ 1,123,446
i) MONEY RECEIVED OR PAID ON YOUR BEHALF
YES
45. BORN BEFORE 1-1-1997?
YES
46. ARE YOU MARRIED?
YES
47. WORKING ON MASTER'S OR DOCTORATE?
YES
48. ON ACTIVE DUTY IN U.S. ARMED FORCES?
YES
49. VETERAN OF U.S. ARMED FORCES?
50. HAVE CHILDREN YOU SUPPORT?
YES
YES
51. DEPENDENTS OTHER THAN CHILDREN/SPOUSE?
52. PARENTS DECEASED, FOSTER CARE, WARD OF COURT? YES
YES
53. ARE/WERE AN EMANCIPATED MINOR?
YES
54. ARE/WERE IN LEGAL GUARDIANSHIP?
55. HOMELESS AS DETERMINED BY HIGH SCHOOL LIAISON? YES
56. HOMELESS AS DETERMINED BY HUD?
YES
57. HOMELESS AS DETERMINED BY DIRECTOR OF
YES
HOMELESS YOUTH CENTER?
58. PARENTS' MARITAL STATUS UNMARRIED AND BOTH PARENTS LIVING
TOGETHER
DECEMBER 1990
59. PARENTS' MARITAL STATUS DATE
XXX-XX-1234
60. PARENT 1 SOCIAL SECURITY NUMBER
ABCDEFGHIJKLMNOP
61. PARENT 1 LAST NAME
62. PARENT 1 FIRST INITIAL
X
JANUARY 23, 1973
63. PARENT 1 DATE OF BIRTH
XXX-XX-1234
64. PARENT 2 SOCIAL SECURITY NUMBER
ABCDEFGHIJKLMNOP
65. PARENT 2 LAST NAME
66. PARENT 2 FIRST INITIAL
D
67. PARENT 2 DATE OF BIRTH
JANUARY 24, 1972
68. PAR EMAIL [email protected]
69. PARENTS' STATE OF LEGAL RESIDENCE
AB
70. LEGAL RESIDENT BEFORE JANUARY 1, 2015? NO
71. DATE PARENT BECAME LEGAL RESIDENT
DECEMBER 2012

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1. LAST NAME
SMITH
2. FIRST NAME
JOHN
3. MIDDLE INITIAL
4. ADDRESS 12344 ABCDEFGHIJKLMNOPQRSTUVWXYZABC
5. CITY
ABCDEFGHIJKLMNOP
6. STATE ABBREVIATION
AB
7. ZIP CODE
12345
8. SOCIAL SECURITY NUMBER
XXX-XX-1234
9. DATE OF BIRTH
JANUARY 30, 1992
10. YOUR TELEPHONE NUMBER
(999)999-9999
11. DRIVER'S LICENSE NUMBER
A-1234-446-789-012-3
12. DRIVER'S LICENSE STATE ABBREVIATION
AB
13. ST E-MAIL
(ELIG NONCIT ASSUMED)
14. CITIZENSHIP STATUS
15. ALIEN REGISTRATION NUMBER
A123446789
(MARRIED ASSUMED)
16. MARITAL STATUS
17. DATE OF MARITAL STATUS
JANUARY 2005
18. STATE OF LEGAL RESIDENCE ABBREVIATION AB
19. LEGAL RESIDENT BEFORE JANUARY 1, 2015? NO
20. DATE YOU BECAME A LEGAL RESIDENT
JANUARY 2012
21. ARE YOU MALE OR FEMALE?
MALE
22. REGISTER YOU WITH SELECTIVE SERVICE?
REGISTER ME
23. DRUG CONVICTION AFFECTING ELIGIBILITY? ELIGIBLE FOR AID
24. PARENT 1 EDUCATIONAL LEVEL
COLLEGE
25. PARENT 2 EDUCATIONAL LEVEL
COLLEGE
26. HIGH SCHOOL COMPLETION STATUS? GED/STATE CERTIFICATE
27.a HS NAME PRINCE GEORGE'S COUNTY HIGH SCHOOL
27.b HS CITY BELTSVILLE
27.c HS STATE MD
28. FIRST BACHELOR'S DEGREE BY 7-1-2020?
YES
29. GRADE LEVEL IN COLLEGE IN 2020-2021
1ST PREV ATTENDED
30. TYPE OF DEGREE/CERTIFICATE
1ST BA
31. INTERESTED IN WORK-STUDY?
YES
32. FILED 2018 INCOME TAX RETURN
WILL FILE
33. TYPE OF 2018 TAX FORM USED
U.S. TRUST TERRITORY
MARRIED-FILED SEPARATE
34. TAX RETURN FILING STATUS 2018
RETURN
35. STUDENT FILED SCHEDULE 1?
YES
36. ADJUSTED GROSS INCOME FROM IRS FORM $ (-1,123,456 ASSUMED)
$ (0 ASSUMED)
37. U.S. INCOME TAX PAID
38. STUDENT'S INCOME EARNED FROM WORK $ (1,123,456 ASSUMED)
39. SPOUSE'S INCOME EARNED FROM WORK $ (1,123,456 ASSUMED)
$ 1,123,456
40. CASH, SAVINGS, AND CHECKING
41. NET WORTH OF INVESTMENTS
$ 1,123,456

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93. NUMBER OF FAMILY MEMBERS IN 2020-2021
94. NUMBER IN COLLEGE IN 2020-2021
95. STUDENT RECEIVED MEDICAID OR SSI?
NO
96. RECEIVED SNAP?
NO
97. RECEIVED FREE/REDUCED PRICE LUNCH?
NO
98. RECEIVED TANF?
NO
99. RECEIVED WIC?
100. STUDENT OR SPOUSE A DISLOCATED WORKER?
NO
101.a FIRST COLLEGE NAME
THE PENNSYLVANIA STATE UNIVERSITY NEW KENSINGTON CAMPUS COMMON

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03
2
YES
YES
YES
YES
YES
WILL FILE
IRS 1040
MARRIED-FILED SEPARATE
RETURN
DON'T KNOW
82. PARENT FILED SCHEDULE 1?
83. EITHER OF PARENTS A DISLOCATED WORKER? YES
84. ADJUSTED GROSS INCOME FROM IRS FORM $ (-1,123,456 ASSUMED)
$ (0 ASSUMED)
85. U.S. INCOME TAX PAID
$ (1,123,456 ASSUMED)
86. PARENT 1 INCOME EARNED FROM WORK
$ (1,123,456 ASSUMED)
87. PARENT 2 INCOME EARNED FROM WORK
$ 1,123,456
88. CASH, SAVINGS, AND CHECKING
$ 1,123,456
89. NET WORTH OF INVESTMENTS
90. NET WORTH OF BUSINESS/INVESTMENT FARMS $ 1,123,456
91. PARENTS' ADDITIONAL FINANCIAL INFORMATION
$ 1,112,345
a) EDUCATION CREDITS
$ 1,112,345
b) CHILD SUPPORT PAID
$ 1,112,345
c) TAXABLE EARNINGS NEED-BASED EMPLOYMENT
d) COLLEGE GRANT AND SCHOLARSHIP AID REPORTED $ 1,112,345
$ 1,112,345
e) COMBAT PAY/SPECIAL COMBAT PAY
$ 1,112,345
f) COOPERATIVE EDUCATION PROGRAM EARNINGS
92. PARENTS' UNTAXED INCOME
$ 1,112,345
a) TAX-DEFERRED PENSIONS/SAVINGS
$ 1,112,345
b) IRA DEDUCTIONS AND PAYMENTS
$ 1,112,345
c) CHILD SUPPORT RECEIVED
$ 1,112,345
d) TAX-EXEMPT INTEREST INCOME
e) UNTAXED PORTIONS OF IRA DISTRIBUTIONS/PENSIONS $ 1,112,345
$ 1,112,345
f) MILITARY OR CLERGY ALLOWANCES
$ 1,112,345
g) VETERANS NONEDUCATION BENEFITS
$ 1,112,345
h) OTHER UNTAXED INCOME

72. NUMBER OF FAMILY MEMBERS IN 2020-2021
73. NUMBER IN COLLEGE IN 2020-2021
74. PARENT RECEIVED MEDICAID OR SSI?
75. RECEIVED SNAP?
76. RECEIVED FREE/REDUCED PRICE LUNCH?
77. RECEIVED TANF?
78. RECEIVED WIC?
79. PARENT(S) FILED 2018 TAX RETURN
80. TYPE OF 2018 TAX FORM USED
81. TAX RETURN FILING STATUS 2018

101.b FIRST HOUSING PLAN ON CAMPUS
101.c SECOND COLLEGE NAME
VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY
101.d SECOND HOUSING PLAN OFF CAMPUS
101.e THIRD COLLEGE NAME
UNIVERSITY OF MARYLAND COLLEGE PARK
101.f THIRD HOUSING PLAN ON CAMPUS
101.g FOURTH COLLEGE NAME
UNIVERSITY OF MASSACHUSETTS AMHERST

101.h FOURTH HOUSING PLAN OFF CAMPUS
NOVEMBER 23, 2020
102. DATE COMPLETED
STUDENT
103. SIGNED BY
104. PREPARER'S SOCIAL SECURITY NUMBER REPORTED
REPORTED
105. PREPARER'S EIN
SIGNED
106. PREPARER'S SIGNATURE

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
https://fafsa.gov and select "View or Print your Student Aid Report (SAR)" after logging in.

For Financial Aid Office Use Only

2A
Transaction Source:
Expected Family Contribution: Primary 000000
Y
Verification Flag:
Secondary 000000
Y
Automatic Zero EFC Flag:
Y
SAR C Flag:
2
Formula Type:
Application Receipt Date: 11/23/2020
Y
Simplified Needs Test Flag:
Transaction Process Date: 11/23/2020
Transaction Receipt Date: 11/23/2020
Special Circumstances:
1
Y
High School Flag:
IRS Request Flag: Student: 01 Parent: 01
4
N
SSN Match Flag:
Selective Service Registration Flag:
4
999999999999999
DHS Match Flag:
DHS Verification #:
N
8
DHS Sec. Conf. Flag:
VA Match Flag:
1
2
NSLDS Match Flag:
NSLDS Results Flag:
1
NSLDS Transaction Number:
NSLDS Unusual Enrollment History Flag: 1
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

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Verification Selection Change Flag: C
Professional Judgment: Y
X
Dependency Status:
Dependency Override:
Hold Code:
Y
Pell Eligible Flag:
Duplicate SSN Flag:
N
IRS Display Flag: Student: A Parent: C
Selective Service Match:
A
SSA Citizenship Code:
4
P1SSN Match Flag:
8
P2SSN Match Flag:
Y
CFH Indicator:

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