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[(Chec)-20(k this bo)20(x if this student w)19(as)]TJ
-8.19766 -1.36364 TD
[(issued a SEVIS identif)20(ication number and enter that)]TJ
T*
[(number in the bo)20(x on line 105.)]TJ
ET
Q
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q
BT
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(106)Tj
ET
Q
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q
BT
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(Social Security Income )Tj
ET
Q
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q
BT
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11 0 0 11 60.696 526.7912 Tm
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(Please enter the total amount this student r)Tj
16.49772 0.00001 TD
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-16.49772 -1.36364 TD
[(ally in benef)20(its fr)19(om the Social Secur)-19(ity
)79(Administr)20(ation.)]TJ
ET
Q
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q
BT
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(107)Tj
ET
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BT
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[(Child T)125(rust )]TJ
ET
Q
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q
BT
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[(If a trust is held in this c)-20(hild's name)-30(,)-206(please enter
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ET
Q
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q
BT
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ET
Q
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BT
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[(Mor)-19(tgage Pa)41(yment)]TJ
ET
Q
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q
BT
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(Please enter the amount of your monthly mor)Tj
17.31071 0 TD
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(tgag)Tj
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(e )Tj
-18.89908 -1.36364 TD
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(payment her)Tj
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(e)Tj
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(.)Tj
ET
Q
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q
BT
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(402)Tj
ET
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q
BT
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(est Paid)Tj
ET
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BT
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(Please enter the amount of inter)Tj
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5.15192 0.00001 TD
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(ear)Tj
1.18017 0.00001 TD
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(If this is not available on your)Tj
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0 Tw
(mor)Tj
1.54077 0.00001 TD
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[(tgag)15(e statement,)-206(please call your mor)-40(tgag)15(e holder
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-1.54077 -1.36364 TD
(g)Tj
0.41186 0 TD
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ET
Q
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q
BT
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ET
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q
BT
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(Is y)Tj
1.35886 0.00001 TD
[(our home o)11(wners insurance included in y)21(our)]TJ
-1.35886 -1.36364 TD
0 Tw
[(mor)-20(tgage?)]TJ
ET
Q
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q
BT
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[(Chec)-20(k y)20(es or no)]TJ
ET
Q
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q
BT
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ET
Q
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q
BT
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[(Original Mor)-20(tgage )151(V)60(alue)]TJ
ET
Q
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q
BT
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[(When you f)20(ir)-20(st bought this house)-30(,)-206(ho)20(w m)10(uc)20(h did you)]TJ
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[(mor)-40(tgag)15(e?)]TJ
ET
Q
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q
BT
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(406)Tj
ET
Q
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q
BT
/F5 1 Tf
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(Y)Tj
0.47412 0.00001 TD
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ET
Q
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BT
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(Please enter the y)Tj
6.73325 0.00001 TD
(ear you or)Tj
3.90396 0.00001 TD
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ET
Q
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q
BT
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(407)Tj
ET
Q
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q
BT
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[(Pur)25(chase Price)]TJ
ET
Q
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q
BT
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[(Ho)20(w m)9(uc)-20(h did you or)-19(iginally pay f)14(or this
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ET
Q
/GS2 gs
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q
BT
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(408)Tj
ET
Q
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q
BT
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(Pr)Tj
0.88598 0.00001 TD
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4.53489 0.00001 TD
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(et )Tj
0.968 0.00001 TD
(V)Tj
0.54394 0.00001 TD
(alue)Tj
ET
Q
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q
BT
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(What is the pr)Tj
5.58506 0.00001 TD
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(et value of your house?)Tj
ET
Q
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q
BT
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0 0.996 0.988 0 k
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(09)Tj
ET
Q
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BT
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(H)Tj
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[(a)35(v)20(e y)21(ou r)20(efinanced? )]TJ
ET
Q
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BT
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(C)Tj
0.55199 -0.00001 TD
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[(hec)-20(k y)20(es or no)]TJ
ET
Q
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BT
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0.028 Tw
[(What y)20(ear did you r)9(ef)20(inance your house? Ho)20(w m)9(uc)-20(h
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(y)Tj
0.37495 -0.00001 TD
[(ou r)10(ef)19(inance?)]TJ
ET
Q
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q
BT
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0 0.996 0.988 0 k
(410)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 336.875 698.8638 Tm
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(Principal Remaining)Tj
ET
Q
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q
BT
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[(What is the unpaid balance on your mor)-40(tgag)15(e?)]TJ
ET
Q
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q
BT
/F3 1 Tf
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0 0.996 0.988 0 k
(411)Tj
ET
Q
/GS2 gs
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q
BT
/F5 1 Tf
11 0 0 11 336.875 664.3279 Tm
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-0.097 Tw
[(Pr)25(oper)-19(ty T)125(ax )-125(Paid)]TJ
ET
Q
/GS2 gs
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q
BT
/F11 1 Tf
11 0 0 11 336.696 649.3279 Tm
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0.028 Tw
[(What is your annual pr)20(oper)-40(ty tax bill due fr)20(om
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0 -1.36363 TD
[(county)30(,)-206(and/or state)-30(.)]TJ
ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 312 610.3279 Tm
0 0.996 0.988 0 k
(450)Tj
ET
Q
/GS2 gs
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q
BT
/F5 1 Tf
11 0 0 11 333.5 610.3279 Tm
0 0 0 1 k
[(Mak)31(e/Model)]TJ
ET
Q
/GS2 gs
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q
BT
/F11 1 Tf
11 0 0 11 336.696 595.3279 Tm
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0.028 Tw
[(Please enter the br)20(and and identifying name of your )]TJ
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[(vehic)-20(le)-30(.)-205(Examples would inc)-20(lude a F)15(or)19(d
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T*
[(Dodg)15(e Neon.)]TJ
ET
Q
/GS2 gs
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q
BT
/F3 1 Tf
11 0 0 11 312 545.7919 Tm
0 0.996 0.988 0 k
(451)Tj
ET
Q
/GS2 gs
/GS1 gs
q
BT
/F5 1 Tf
11 0 0 11 335.2261 545.7919 Tm
0 0 0 1 k
[(Y)130(ear)]TJ
ET
Q
/GS2 gs
/GS1 gs
q
BT
/F11 1 Tf
11 0 0 11 336.696 530.7919 Tm
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0.028 Tw
[(Please enter the y)20(ear the vehic)-20(le w)20(as manuf)14(actur)10(ed
)]TJ
0 -1.36364 TD
[(f)15(or sale)-30(.)]TJ
ET
Q
/GS2 gs
/GS1 gs
q
BT
/F3 1 Tf
11 0 0 11 312 496.2559 Tm
0 0.996 0.988 0 k
(452)Tj
ET
Q
/GS2 gs
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q
BT
/F5 1 Tf
11 0 0 11 336.875 496.2559 Tm
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(Estimated )Tj
4.11302 0.00001 TD
[(V)60(alue)]TJ
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 336.696 481.2559 Tm
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0.028 Tw
[(Please enter the pr)10(esent mark)49(et value of your vehic)-19(le
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0 -1.36364 TD
[(sold in curr)10(ent condition.)-206(If you ar)10(e unsur)9(e of the
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(c)'
0.40453 0 TD
[(lic)-20(k the blue link to look it up at K)55(elley Blue Book.)56(Ther)10(e)]TJ
-0.40453 -1.36364 TD
[(is an online link to tak)50(e you to K)55(elley Blue Book.)]TJ
0 -1.776 TD
[(Chec)-20(k if leased \320 Chec)-20(k her)10(e if vehic)-20(le is
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ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 312 397.1839 Tm
0 0.996 0.988 0 k
(453)Tj
ET
Q
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q
BT
/F5 1 Tf
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0.028 Tw
(Debt Outstanding)Tj
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 336.696 382.1839 Tm
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[(Please enter the total amount r)10(emaining on or)-20(iginal )]TJ
0 -1.36364 TD
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3.4501 0 TD
(If you lease this car)Tj
7.33062 0.00001 TD
(,)Tj
0.40376 0 TD
[(enter a z)20(er)19(o.)]TJ
ET
Q
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q
BT
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(454)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 336.875 347.6479 Tm
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[(Pa)41(yment)]TJ
ET
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q
BT
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0.028 Tw
(Please enter the amount you pay eac)Tj
14.10812 0.00001 TD
(h month f)Tj
3.74306 0 TD
0 Tw
(or )Tj
-17.85118 -1.36364 TD
0.028 Tw
[(a loan or a lease on this car)40(.)]TJ
ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 312 269.6479 Tm
0 0.996 0.988 0 k
(501)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 336.875 269.6479 Tm
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[(Home Mark)31(et )150(V)60(alue)]TJ
ET
Q
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q
BT
/F11 1 Tf
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[(This section auto-f)20(ills depending on what you enter)9(ed )]TJ
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2.83315 0.00001 TD
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ET
Q
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q
BT
/F3 1 Tf
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(502)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 336.875 220.1118 Tm
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0.028 Tw
[(Other Real Estate Mark)31(et )150(V)61(alue)]TJ
ET
Q
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q
BT
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[(This section auto-f)20(ills depending on what you enter)9(ed )]TJ
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[(in the F)40(amily Home Inf)15(ormation Section.)]TJ
ET
Q
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BT
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(503)Tj
ET
Q
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q
BT
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[(V)100(ehicle(s) Mark)30(et )150(V)60(alue)]TJ
ET
Q
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q
BT
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[(This section auto-f)20(ills depending on what you enter)9(ed )]TJ
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2.30605 0.00001 TD
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0.42994 0.00001 TD
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1.49951 0.00001 TD
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1.89668 0.00001 TD
(ormation Section.)Tj
ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 312 121.0399 Tm
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(504)Tj
ET
Q
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q
BT
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[(Sa)35(vings)]TJ
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 336.696 106.0399 Tm
0 0 0 0.75 k
0.028 Tw
(Please enter the total amounts of all your savings)Tj
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[(accounts and money mark)50(et accounts)-30(.)-206(Use
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T*
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ET
Q
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[(Cer)-20(tificate of Deposit)]TJ
ET
Q
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T*
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ET
Q
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[(Please enter the amounts as of your last quar)-40(terly)30(,)206(or)]TJ
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T*
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Q
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ET
Q
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q
BT
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11 0 0 11 59.5 509.7919 Tm
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[(T)125(rust & Inheritance)]TJ
ET
Q
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BT
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11 0 0 11 60.696 494.7919 Tm
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T*
[(within the last y)20(ear)39(.)]TJ
ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 36 430.2559 Tm
0 0.996 0.988 0 k
(509)Tj
ET
Q
/GS2 gs
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q
BT
/F5 1 Tf
11 0 0 11 60.875 430.2559 Tm
0 0 0 1 k
0.028 Tw
[(Retir)20(ement Sa)35(vings)]TJ
ET
Q
/GS2 gs
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q
BT
/F11 1 Tf
11 0 0 11 60.696 415.2559 Tm
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0.028 Tw
[(Please enter the total amounts of all 401k,)-206(IRA,)-206(Roth IRA)]TJ
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[(and K)55(eough accounts as of the most r)10(ecent statements)-30(.)]TJ
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q
BT
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(510)Tj
ET
Q
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q
BT
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(Business Assets)Tj
ET
Q
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q
BT
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(If you o)Tj
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ET
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BT
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(511)Tj
ET
Q
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BT
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[(Please enter the total valuation of your tangible assets)-30(.)]TJ
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(or whic)Tj
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BT
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(512)Tj
ET
Q
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BT
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[(Fur)-20(ther Asset )-100(Explanation:)]TJ
ET
Q
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[(Use this space to c)-20(lar)-20(ify any of your ans)10(wer)-20(s in the
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(section.)Tj
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(550)Tj
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BT
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(Home Principal)Tj
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Q
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[(This section auto-f)20(ills depending on what you enter)9(ed )]TJ
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(ther Real Estate Principal)Tj
ET
Q
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[(This section autof)20(ills depending on what you enter)9(ed )]TJ
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[(n the F)40(amily Home Inf)15(ormation Section.)]TJ
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Q
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BT
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(552)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 335.2261 698.8638 Tm
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[(V)100(ehicle Debt Outstanding)]TJ
ET
Q
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BT
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[(This section auto-f)20(ills depending on what you enter)9(ed )]TJ
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[(in the )150(V)80(ehic)-20(le Inf)15(ormation Section.)]TJ
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Q
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q
BT
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(553)Tj
ET
Q
/GS2 gs
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q
BT
/F5 1 Tf
11 0 0 11 336.875 649.3279 Tm
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0.028 Tw
[(P)25(ersonal Loans)]TJ
ET
Q
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q
BT
/F11 1 Tf
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[(Please enter any secur)10(ed or unsecur)9(ed loans you may)]TJ
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T*
[(per)-20(sons)-30(.)-56(The number should be the actual amount
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T*
[(to date)-30(,)-206(not the amount borr)20(o)20(wed.)-206(Do not inc)20(lude cr)10(edit)]TJ
T*
[(car)20(d balances or equity loans in this categ)9(or)-40(y)30(.)]TJ
ET
Q
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q
BT
/F3 1 Tf
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(554)Tj
ET
Q
/GS2 gs
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q
BT
/F5 1 Tf
11 0 0 11 336.875 554.7919 Tm
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0.028 Tw
[(Cr)20(edit Car)15(ds)]TJ
ET
Q
/GS2 gs
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q
BT
/F11 1 Tf
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0.028 Tw
[(Please enter the total amount o)20(wed on all cr)9(edit car)20(ds
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Q
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BT
/F3 1 Tf
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(555)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 336.875 505.2559 Tm
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(Equity Loans)Tj
ET
Q
/GS2 gs
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q
BT
/F11 1 Tf
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0.028 Tw
(Please enter the total of any money that you have bor-)Tj
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ET
Q
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(556)Tj
ET
Q
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q
BT
/F5 1 Tf
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0.028 Tw
[(Equity Inter)20(est Paid)]TJ
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 336.696 440.7199 Tm
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[(Please enter the total of all inter)10(est paid annually on the)]TJ
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[(equity loans listed in 555 abo)20(ve)-30(.)]TJ
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Q
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BT
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(557)Tj
ET
Q
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(Other Liabilities)Tj
ET
Q
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BT
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0.028 Tw
[(Please enter the total amount you o)20(we f)15(or items suc)-20(h
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(cour)Tj
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T*
0 Tw
[(questions)-30(.)]TJ
ET
Q
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q
BT
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(558)Tj
ET
Q
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(Fur)Tj
1.38501 0.00001 TD
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(Use this space to c)Tj
7.20928 0 TD
[(lar)-20(ify any of your ans)10(wer)-20(s in the)]TJ
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(Liability section.)Tj
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Q
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q
BT
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(601)Tj
ET
Q
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1.65698 0.00001 TD
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[(Please enter your gr)20(oss w)19(ag)15(es)-30(,)-206(pr)-20(ior to any
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(W)'
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[(-2\325)50(s f)14(or the pr)-19(ior y)19(ear)40(.)-31(Y)80(our Section
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q
BT
/F3 1 Tf
11 0 0 11 312 169.1118 Tm
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(602)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 336.875 169.1118 Tm
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(Business Income)Tj
ET
Q
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q
BT
/F11 1 Tf
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0.028 Tw
(Please enter the total amount of income r)Tj
15.83267 0.00001 TD
0 Tw
(epor)Tj
1.72876 0.00001 TD
0.028 Tw
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-17.56143 -1.36365 TD
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T*
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7.02285 0.00001 TD
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[(ividend/Inter)20(est Income)]TJ
ET
Q
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BT
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[(Please enter the total amount of all income r)10(eceived)]TJ
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ET
Q
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q
BT
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ET
Q
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q
BT
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0.028 Tw
[(Ca)10(pital Gains Income)]TJ
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 60.696 623.8638 Tm
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0.028 Tw
(Please enter the total amount of capital gains earned )Tj
0 -1.36364 TD
[(as r)10(epor)-40(ted on your f)15(eder)19(al tax r)10(eturn.)]TJ
ET
Q
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BT
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ET
Q
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q
BT
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11 0 0 11 60.875 589.3279 Tm
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0.028 Tw
(Real Estate Income)Tj
ET
Q
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q
BT
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11 0 0 11 60.696 574.3279 Tm
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0.028 Tw
[(Please enter the total amount of all monies r)10(eceived )]TJ
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[(fr)20(om r)9(eal estate curr)10(ently o)20(wned.)-206(Examples inc)20(lude r)10(ental)]TJ
T*
[(pr)20(oper)-40(ties)-30(,)-206(vacation homes)-30(,)-205(and time
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ET
Q
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q
BT
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ET
Q
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q
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[(T)125(rusts)]TJ
ET
Q
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q
BT
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[(Please enter the amount r)10(eceived annually)29(,)-205(as listed
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T*
[(tell us who cr)10(eated the trust,)-206(the intended purpose)-30(,)206(as)]TJ
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ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 36 415.2559 Tm
0 0.996 0.988 0 k
(607)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 59.7739 415.2559 Tm
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0.028 Tw
[(Alimon)20(y Income)]TJ
ET
Q
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q
BT
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11 0 0 11 60.696 400.2559 Tm
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0.028 Tw
[(Please enter the total amount of alimony r)10(eceived dur)-20(ing)]TJ
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[(the last y)20(ear)39(.)]TJ
ET
Q
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q
BT
/F3 1 Tf
11 0 0 11 36 365.7199 Tm
0 0.996 0.988 0 k
(608)Tj
ET
Q
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0.028 Tw
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5.38792 0 TD
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3.27586 0.00001 TD
0 Tw
(ed)Tj
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 60.696 350.7199 Tm
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0.028 Tw
[(Please enter the total amount of Child Suppor)-40(t r)10(eceived)]TJ
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ET
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q
BT
/F3 1 Tf
11 0 0 11 36 316.1839 Tm
0 0.996 0.988 0 k
(609)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 59.7739 316.1839 Tm
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0.028 Tw
(All Other Income)Tj
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 60.696 301.1839 Tm
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0.028 Tw
[(Please enter the total amount of any income not alr)10(eady)]TJ
0 -1.36363 TD
0 Tw
(listed,)Tj
2.32125 0.00001 TD
0.028 Tw
[(inc)-20(luding money r)10(eceived f)15(or par)-40(t time jobs
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0 Tw
(lude)Tj
-17.51652 -1.36366 TD
0.028 Tw
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3.7353 0.00001 TD
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-11.69395 -1.36365 TD
[(benef)20(its)-30(,)-206(gambling,)-206(or social secur)-20(ity
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ET
Q
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q
BT
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0 0.996 0.988 0 k
(610)Tj
ET
Q
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q
BT
/F5 1 Tf
11 0 0 11 60.875 206.6479 Tm
0 0 0 1 k
0.028 Tw
[(Fur)-20(ther Income Explanation:)]TJ
ET
Q
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q
BT
/F11 1 Tf
11 0 0 11 60.875 191.6479 Tm
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