2015 – 2016 Non-Custodial 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 Non-Custodial Parent Information Worksheet Instructions. For
questions where the Instructions provide a list of possible answers, enter the applicable answer in this worksheet. For
example, for question 62v, 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
Non-Custodial Parent 1 is your legal parent whose information was not previously provided in Step 5: Parent Form. NonCustodial Parent 2 is the spouse of Non- Custodial Parent 1, if applicable.
Non-Custodial Parent 2 is the spouse of Non-Custodial Parent 1. If Non-Custodial Parent 1’s Current Marital Status is Single,
Separated, or Divorced, skip Non-Custodial Parent 2 questions. If Non-Custodial Parent 1 is Widowed, answer only 62ay
from the Non-Custodial Parent 2 section.
Non-Custodial Parent 1
Non-Custodial Parent 2
61c, 62c
Name:
_______________________
_______________________
61cm, 62cm
Date of Birth:
______/_______/_________
______/_______/_________
61d, 62d
Street:
_______________________
_______________________
61e, 62e
City:
_______________________
_______________________
61f, 62f
State:
_______________________
_______________________
61g, 62g
Zip Code:
_______________________
_______________________
61h, 62h
Territory/Country:
_______________________
_______________________
c237df, dm
E-mail Address:
_______________________
_______________________
62v
Current Marital Status of Non-Custodial Parent 1: _______________
62ay
Year Non-Custodial Parent 2/Stepparent/Guardian Died, if applicable:
_______________________
61i, 62i
Occupation:
_______________________
_______________________
61j, 62j
Job Title:
_______________________
_______________________
61k, 62k
Employer:
_______________________
_______________________
61m, 62m
Number of Years with this Employer:
_______________________
_______________________
2015-2016 Need Access Non-Custodial Parent Answer Form, Page 1 of 5
Parents’ Household Information
62p. Phone Number: (___) ___________________________
62pe. Parents’ E-mail Address: ________________________
62qp. Parent Last Claimed Student as Dependent: ____________
62qy. Last Year Claimed: ___________
62r. Parents’ Release of Financial Data (Yes, No): _______
62s. Number of Family Members Financially Supported by Parents: ___________
62t. Number in College in 2015-2016: ___________
62tt. Federal Benefits Received in 2013 or 2014: __________
62u. Number of Parents in College: ___________
62wm, 62wy Date of Divorce/Separation: Month _____ Year _____
62wrm, 62wry. Date of Remarriage: Month ____ Year ____
62x. State of Legal Residence: _______________
c20d. Parents Living Abroad: _________
62z. 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.
63, 64a. 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
63, 64b. Number of Exemptions:
____________________
____________________
63, 64c. Adjusted Gross Income from IRS Form:
$____________________
$____________________
63, 64d. Itemized Deductions (1040 Schedule A):
$____________________
$____________________
63, 64e. U.S. Income Tax Paid:
$____________________
$____________________
63, 64f. Non-Custodial Parent 1 Earned Income:
$____________________
$____________________
63, 64g. Non-Custodial Parent 2 Earned Income:
$____________________
$____________________
63, 64h. Interest Income:
$____________________
$____________________
63, 64i. Dividend Income:
$____________________
$____________________
63,64j. Other Taxable Income:
$____________________
$____________________
63, 64k. Earned Income Credit:
$____________________
$____________________
63, 64m. Social Security Benefits:
$____________________
$____________________
63, 64n. AFDC/TANF:
$____________________
$____________________
63, 64o. Child Support Received:
$____________________
$____________________
63, 64p. Other Untaxed Income/Benefits:
$____________________
$____________________
63, 64q. Medical/Dental Expense:
$____________________
$____________________
63, 64r. Elementary/Junior/High School Tuition:
$____________________
$____________________
____________________
____________________
63, 64t. Child Support Paid:
$____________________
$____________________
63, 64u. Education Credits Received:
$____________________
$____________________
63, 64v. Taxable Income Exclusion:
$____________________
$____________________
63, 64s. Number of Children's Tuition Paid -
2015-2016 Need Access Non-Custodial Parent Answer Form, Page 2 of 5
Parents’ Assets
66a. Cash, Savings, and Checking Accounts (Today):
Value
$____________________
66b, 66c. If Home is Owned, Home:
$____________________
66d. If Home is Owned, Year Purchased:
Debt
$____________________
____________________
66e. If Home is Owned, Home Purchase Price:
$____________________
66f, 66g. Other Real Estate
$____________________
$____________________
66h, 66i. Investments
$____________________
$____________________
66j, 36k. Business:
$____________________
$____________________
66ka. Small Family-Run Business (Yes, No):
____________________
66m, 66n. Farm:
$____________________
66o. Family Lives on Farm (Yes, No):
$____________________
____________________
66p. Retirement Accounts Value:
$____________________
Parents’ Household Expenses
69a. Home Monthly Rent/Mortgage
$__________
69b. State and Local Taxes – 2014 $____________
69c. Own or Lease a Vehicle: (Own, Lease, Own and Lease, None): ____________________
Vehicle 1. 69d. Model Year: _____ 69e. Make: ____________________
69f. Model: ______________________
Vehicle 2. 69g. Model Year: _____ 69h. Make: ____________________
69i. Model: ______________________
69j. Total Vehicle Indebtedness: $ _____________
69.k. Total Monthly Vehicle Payments: $_________________
Parents’ Household Members
(71) Non-Custodial Parent 1 Information
71d. College Student (Yes, No):
_____________
(72) Non-Custodial Parent 2 Information
72d. College Student (Yes, No):
___________
71e. School/College/Institution
_____________
72e. School/College/Institution
___________
71f. Class – 2015-2016:
_____________
72f. Class – 2015-2016:
___________
71n. Tuition and Fees for 2015-2016
$____________
72n. Tuition and Fees for 2015-2016
$__________
Parents’ Other Household Members
Name:
73a.
(73) Parents’ Other
Household Member 1
_________________
74a.
(74) Parents’ Other
Household Member 2
_________________
Age:
73b.
_________________
74b.
_________________
Relationship to Student:
73c.
_________________
74c.
_________________
College Student - 2015-2016 (Yes, No):
73d.
_________________
74d.
_________________
School/College/Institution - 2015-2016:
73e.
_________________
74e.
_________________
Class – 2015-2016:
73f.
_________________
74f.
_________________
Assistance from Parents – 2015-2016:
73g.
$_________________
74g.
$_________________
School/College/Institution - 2014-2015:
73h.
_________________
74h.
_________________
Assistance from Parents – Last Year in School:
73m.
$________________
74m.
$________________
2015-2016 Need Access Non-Custodial Parent Answer Form, Page 3 of 5
Name:
75a.
(75) Parents’ Other
Household Member 3
_________________
76a.
(76) Parents’ Other
Household Member 4
_________________
Age:
75b.
_________________
76b.
_________________
Relationship to Student:
75c.
_________________
76c.
_________________
College Student 2015-2016 (Yes, No):
75d.
_________________
76d.
_________________
School/College/Institution 2015-2016:
75e.
_________________
76e.
_________________
Class – 2015-2016:
75f.
_________________
76f.
_________________
Assistance from Parents – 2015-2016:
75g.
$_________________
76g.
$_________________
School/College/Institution 2014-2015:
75h.
_________________
76h.
_________________
Assistance from Parents – Last Year in
75m.
$________________
76m.
$________________
Name:
77a.
(77) Parents’ Other
Household Member 5
_________________
78a.
(78) Parents’ Other
Household Member 6
_________________
Age:
77b.
_________________
78b.
_________________
Relationship to Student:
77c.
_________________
78c.
_________________
College Student 2015-2016 (Yes, No):
77d.
_________________
78d.
_________________
School/College/Institution 2015-2016:
77e.
_________________
78e.
_________________
Class – 2015-2016:
77f.
_________________
78f.
_________________
Assistance from Parents – 2015-2016:
77g.
$_________________
78g.
$_________________
School/College/Institution 2014-2015:
77h.
_________________
78h.
_________________
Assistance from Parents – Last Year in
77m.
$________________
78m.
$________________
School:
School:
2015-2016 Need Access Non-Custodial Parent Answer Form, Page 4 of 5
Parent’s Special Circumstances
89. 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 Non-Custodial Parent Answer Form, Page 5 of 5