DAS
2016-17
Contact:
Please complete and return form to:
Financial Aid Office
UW-Stout
210 Bowman Hall
802 S. Broadway Street
Menomonie, WI 54751
Contact Information:
Phone: (715) 232-1363
Fax: (715) 232-5246
E-mail: finaid1@uwstout.edu
ASSET SUPPLEMENT
Student Name: __________________________________________________________________________________
Stout ID Number: ________________________________________________________________________________
Parent’s Name: __________________________________________________________________________________
Parent’s Home Address: ___________________________________________________________________________
Parent’s Phone Number: ____________________________Parent’s E-mail: _________________________________
Assets reported on the FAFSA are a snapshot at time of completion. Regulations do not allow updating this information. You are
being asked to complete this form because either you changed your assets, did not report any assets, but are required to do so, or
your assets do not match the interest/dividend reported on your tax forms. If the figures below represent a change, please explain.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
ASSETS
PLEASE COMPLETE EVERY BLANK AS OF TODAY. IF THERE IS NO VALUE, PUT IN A "0".
DO NOT include the home you live in, value of life insurance or retirement plans (pension funds, annuities, non-education IRAs,
Keogh plans, 401K plans, etc.)
DO include real estate, trust funds, money market funds, mutual funds, certificates of deposit, stocks, stock options, bonds, other
securities, installment and land sale contracts, Coverdell savings accounts, 529 college savings plans, UGMA and UTMA
accounts, and the refund value of 529 state prepaid tuition plans. If the qualified education savings account is owned by the
student, and parental information is on the FAFSA, the value of the account is reported as parental assets.
STUDENT
PARENT(S)
$
_.00
$
_.00
Current net worth of investments and real estate
(Investment value minus investment debt)
$
.00
$
.00
Current net worth of business
(Business market value minus business debt)
$
.00
$
.00
$
.00
$
.00
Total current balance of cash, savings, and
checking accounts
Do not include the value of a small business which you (or your
spouse) own and control and which has 100 or fewer full-time (or
full-time equivalent) employees.
Current net worth of investment farm
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
I certify that all information reported to qualify for federal student aid is complete and correct.
____________________________________________ _________________________________________________
Student Signature
Date
Parent Signature
Date