2015 – 2016 Parent Answer Form
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Use this Answer Form if you prefer to prepare your financial data on paper before entering it in the online Need Access
Application at www.needaccess.org. Do not mail or fax any paper forms to Access Group.
If parents are separated or divorced, the main supporting parent (and stepparent, if applicable) should complete the
Parent Form. The other parent (and stepparent, if applicable) should complete the Non-Custodial Parent Form.
This Answer Form is designed to be used with the Parent Information Worksheet Instructions. For questions where
these Instructions provide a list of possible answers, enter the applicable answer in this worksheet. For example, for
question 32v, which asks the parents’ Current Marital Status, fill in the applicable choice, such as Single,
Married/unmarried and both parents living together, Separated, Divorced, or Widowed. (Do not enter the number
shown.)
Please enter all dollar amounts in whole dollars only.
Student Name: ____________________
Student SSN: ______________________
Student Date of Birth: __________
Parents/Stepparents/Guardian Information
Parent 1 is your main supporting parent or parent who most recently provided the greatest financial support (see Parent
Information Worksheet Instructions for more details.) Parent 2 is the spouse of Parent 1, if applicable.
Parent 2 is the spouse of Parent 1, or is the student’s other legal parent if the parents are unmarried and both parents live
together. If Parent 1’s Current Marital Status is Single, Separated, or Divorced, skip Parent 2 questions. If Parent 1 is
Widowed, answer only 32ay from the Parent 2 section.
Parent 1
Parent 2
31c, 32c
Name:
_______________________
_______________________
31cm, 32cm
Date of Birth:
______/_______/_________
______/_______/_________
31d, 32d
Street:
_______________________
_______________________
31e, 32e
City:
_______________________
_______________________
31f, 32f
State:
_______________________
_______________________
31g, 32g
Zip Code:
_______________________
_______________________
31h, 32h
Territory/Country:
_______________________
_______________________
c237pf, pm
E-mail Address:
_______________________
_______________________
32v
Current Marital Status of Parent 1:
_______________________
32ay
Year Parent 2/Stepparent/Guardian Died, if applicable:
_______________________
31i, 32i
Occupation:
_______________________
_______________________
31j, 32j
Job Title:
_______________________
_______________________
31k, 32k
Employer:
_______________________
_______________________
31m, 32m
Number of Years with this Employer:
_______________________
_______________________
2015-2016 Need Access Parent Answer Form, Page 1 of 5
Parents’ Household Information
32p. Phone Number: (___) ___________________________
32pe. Parents’ E-mail Address: ________________________
32qp. Parent Last Claimed Student as Dependent: ____________
32qy. Last Year Claimed: ___________
32r. Parents’ Release of Financial Data (Yes, No): _______
32s. Number of Family Members Financially Supported by Parents: ___________
32t. Number in College in 2015-2016: ___________
32tt. Federal Benefits Received in 2013 or 2014: ___________
32u. Number of Parents in College: ___________
32wm, 32wy Date of Divorce/Separation: Month _____ Year _____
32wrm, 32wry. Date of Remarriage: Month ____ Year ____
32x. State of Legal Residence: _______________
c20p. Parents Living Abroad (Yes/No): _________
32z. Income from Non-U.S. Sources in 2014 (Yes/No): _________
Parents’ Income and Expenses
Schools may require one or both years of income and expense data.
33, 34a. Source of Following U.S. Tax Figures:
2014
____________________
2015 (Estimated)
____________________
Completed IRS Form 1040A or 1040EZ; Completed IRS Form 1040; Estimated IRS Form 1040A or 1040EZ;
Estimated IRS Form 1040; Tax return will not be filed; Completed IRS Form 1040NR, Estimated IRS Form 1040NR
33, 34b. Number of Exemptions:
____________________
____________________
33, 34c. Adjusted Gross Income from IRS Form:
$____________________
$____________________
33, 34d. Itemized Deductions (1040 Schedule A):
$____________________
$____________________
33, 34e. U.S. Income Tax Paid:
$____________________
$____________________
33, 34f. Parent 1’s Earned Income:
$____________________
$____________________
33, 34g. Parent 2’s Earned Income:
$____________________
$____________________
33, 34h. Interest Income:
$____________________
$____________________
33, 34i. Dividend Income:
$____________________
$____________________
33,34j. Other Taxable Income:
$____________________
$____________________
33, 34k. Earned Income Credit:
$____________________
$____________________
33, 34m. Social Security Benefits:
$____________________
$____________________
33, 34n. AFDC/TANF:
$____________________
$____________________
33, 34o. Child Support Received:
$____________________
$____________________
33, 34p. Other Untaxed Income/Benefits:
$____________________
$____________________
33, 34q. Medical/Dental Expense:
$____________________
$____________________
33, 34r. Elementary/Junior/High School Tuition:
$____________________
$____________________
____________________
____________________
33, 34t. Child Support Paid:
$____________________
$____________________
33, 34u. Education Credits Received:
$____________________
$____________________
33, 34v. Taxable Income Exclusion:
$____________________
$____________________
33,34s. Number of Children's Tuition Paid:
2015-2016 Need Access Parent Answer Form, Page 2 of 5
Parents’ Assets
36a. Cash, Savings, and Checking Accounts (Today):
Value
$____________________
36b, 36c. If Home is Owned, Home:
$____________________
36d. If Home is Owned, Year Purchased:
Debt
$____________________
____________________
36e. If Home is Owned, Home Purchase Price:
$____________________
36f, 36g. Other Real Estate
$____________________
$____________________
36h, 36i. Investments
$____________________
$____________________
36j, 36k. Business:
$____________________
$____________________
36ka. Small Family-Run Business (Yes, No):
____________________
36m, 36n. Farm:
$____________________
36o. Family Lives on Farm (Yes, No):
$____________________
____________________
36p. Retirement Accounts Value:
$____________________
Parents’ Household Expenses
39a. Home Monthly Rent/Mortgage
$__________
39b. State and Local Taxes – 2014 $____________
39c. Own or Lease a Vehicle: (Own, Lease, Own and Lease, None): ____________________
Vehicle 1. 39d. Model Year: _____ 39e. Make: ____________________
39f. Model: ______________________
Vehicle 2. 39g. Model Year: _____ 39h. Make: ____________________
39i. Model: ______________________
39j. Total Vehicle Indebtedness: $ _____________
39.k. Total Monthly Vehicle Payments: $_________________
Parents’ Household Members
(41) Parent 1 Information
41d. College Student (Yes, No):
_____________
(42) Parent 2 Information
42d. College Student (Yes, No):
___________
41e. School/College/Institution:
_____________
42e. School/College/Institution:
___________
41f. Class – 2015-2016:
_____________
42f. Class – 2015-2016:
___________
41n. Tuition and Fees for 2015-2016
$____________
42n. Tuition and Fees for 2015-2016
$__________
Parents’ Other Household Members
Name:
43a.
(43) Parents’ Other
Household Member 1
_________________
44a.
(44) Parents’ Other
Household Member 2
_________________
Age:
43b.
_________________
44b.
_________________
Relationship to Student:
43c.
_________________
44c.
_________________
College Student - 2015-2016 (Yes, No):
43d.
_________________
44d.
_________________
School/College/Institution - 2015-2016:
43e.
_________________
44e.
_________________
Class – 2015-2016:
43f.
_________________
44f.
_________________
Assistance from Parents – 2015-2016:
43g.
$________________
44g.
$_________________
School/College/Institution - 2014-2015:
43h.
________________
44h.
_________________
Assistance from Parents–Last Year in School:
43m.
$________________
44m.
$________________
2015-2016 Need Access Parent Answer Form, Page 3 of 5
(45) Parents’ Other
(46) Parents’ Other
Household Member 3
Household Member 4
Name:
45a.
_________________
46a.
_________________
Age:
45b.
_________________
46b.
_________________
Relationship to Student:
45c.
_________________
46c.
_________________
College Student 2015-2016 (Yes, No):
45d.
_________________
46d.
_________________
School/College/Institution 2015-2016:
45e.
_________________
46e.
_________________
Class – 2015-2016:
45f.
_________________
46f.
_________________
Assistance from Parents – 2015-2016:
45g.
$_________________
46g.
$_________________
School/College/Institution 2014-2015:
45h.
_________________
46h.
_________________
Assistance from Parents – Last Year in
45m.
$________________
46m.
$________________
School:
(47) Parents’ Other
(48) Parents’ Other
Household Member 5
Household Member 6
Name:
47a.
_________________
48a.
_________________
Age:
47b.
_________________
48b.
_________________
Relationship to Student:
47c.
_________________
48c.
_________________
College Student 2015-2016 (Yes, No):
47d.
_________________
48d.
_________________
School/College/Institution 2015-2016:
47e.
_________________
48e.
_________________
Class – 2015-2016:
47f.
_________________
48f.
_________________
Assistance from Parents – 2015-2016:
47g.
$_________________
48g.
$_________________
School/College/Institution 2014-2015:
47h.
_________________
48h.
_________________
Assistance from Parents – Last Year in
47m.
$________________
48m.
$________________
School:
2015-2016 Need Access Parent Answer Form, Page 4 of 5
Parent’s Special Circumstances
59. This section is not required of you to complete. Enter any special circumstance that you wish the school(s) to consider in
their assessment of this application. If you do choose to add an explanation of your special circumstance, the financial aid
administrator at the schools to which the application is being submitted may take your explanation into consideration.
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2015-2016 Need Access Parent Answer Form, Page 5 of 5