2013-2014 Transfer Application for Financial Aid This application will assist us in determining your eligibility for Le Moyne College financial aid. It also helps us estimate your eligibility for federal grant, loans, and work-study opportunities and your potential eligibility for New York State Tuition Assistance Program (TAP). You MUST complete the 2013-2014 Free Application for Federal Student Aid (FAFSA) as soon after January 1, 2013 as possible to confirm your eligibility. The Le Moyne College Federal School Code to use when completing the FAFSA is 002748 Last Name* First Name* Social Security Number* Permanent Address Street* City* State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Please select Zip Code* Home Telephone Student Cellphone Number* Email Address* Section A: Family Member ListingList all household members other than yourself, including your parents and any children they will support between July 1, 2013 and June 30, 2014. Include other people if they received more than one half of their support from your parents and will continue to receive this support between July 1, 2013 and June 30, 2014. Full Name of First Family Member (student applicant) Age Relationship Code Please Select Student Parent Student Stepparent Student Sibling Student Husband/Wife Student Son/Daughter Student Grandparent 2013-2014 School Year Attending Please Select Full Time Part Time College Name 2012-2013 School Year College Name Year Total Aid Parent Contribution Full Name of Additional Family Member Age Relationship Code Please Select Student Parent Student Stepparent Student Sibling Student Husband/Wife Student Son/Daughter Student Grandparent 2013-2014 School Year Attending Please Select Full Time Part Time College Name 2012-2013 School Year College Name Year Total Aid Parent Contribution Full Name of Additional Family Member Age Relationship Code Please Select Student Parent Student Stepparent Student Sibling Student Husband/Wife Student Son/Daughter Student Son/Daughter Student Grandparent 2013-2014 School Year Attending Please Select Full Time Part Time College Name 2012-2013 School Year College Name Year Total Aid Parent Contribution Full Name of Additional Family Member Age Relationship Code Please Select Student Parent Student Stepparent Student Sibling Student Husband/Wife Student Son/Daughter Student Grandparent 2013-2014 School Year Attending Please Select Full Time Part Time College Name 2012-2013 School Year College Name Year Total Aid Parent Contribution Full Name of Additional Family Member Age Relationship Code Please Select Student Parent Student Stepparent Student Sibling Student Husband/Wife Student Son/Daughter Student Grandparent 2013-2014 School Year Attending Please select Full Time Part Time College Name 2012-2013 School Year College Name Year Total Aid Parent Contribution Section B Income and Asset Information of Student and Spouse Federal Adjusted Gross Income 2012 Expected 2013 Social Security 2012 Expected 2013 Cash, Savings & Checking Accounts Investments (including Uniform Gifts to Minors or college savings plans) Outside sources of tuition assistance (benefits/scholarships) Expected 2013 Employee Benefits Scholarships Veterans Benefits Other Section C: Parent Information Please choose Please Select Father Stepfather Legal Guardian Other Please choose Please Select Mother Stepmother Legal Guardian Other Name Age Name Age Mark IfSelf-EmployedUnemployed Date of Last Employment Mark IfSelf-EmployedUnemployed Date of Last Employment Occupation Occupation Employer Employer Business Phone Business Phone Email Address Email Address Section D: Divorced, Separated or Remarried Parents(To be completed by the parent who completes the form, if the student's natural or adoptive parents are divorced, separated or remarried) Year of Separation Year of Divorce Who last claimed the student as a tax exemption Other Parent's Name Name Home Address In which year Occupation/Employer How does the other parent plan to contribute to the student's education for the 2012-2013 school year? According to court order when will support for the student end? Is there an agreement specifying the contribution for the student's education?YesNo Section E Parents' Income 2012 Estimated 2013 Federal Adjusted Gross Income (AGI) Income earned from work by father Income earned from work by mother Federal Income Taxes Paid Interest Income Dividend Income Net income (or loss) from business, farm, rents, royalties, partnerships, estates, trusts, etc. If a loss, enter the amount in parenthesis Other taxable income such as alimony received, capital gains (or losses), pensions, annuities, etc. Child Support received for this student Total for all Other nontaxable income (specify source) Social Security Benefits Payment to tax-deferred retirement plan (paid by employee) Child Support paid Section F Parents' Assets Cash, savings and checking accounts Investments (do not include retirement accounts, i.e. IRA, Roth) What is it worth today? What is owed on it? Home (renters enter "0") Other real estate (don't include business or farm) BusinessFarm value (check one) Parents' monthly home mortgage If parents own home, year purchased If parents own home, purchase price Section G - Previous Colleges Attended Section H: Special CircumstancesPlease explain any extraordinary circumstances of which you feel the Office of Financial Aid should be made aware. Section I: Signatures (Student's and Parents' Required)I (we) certify that the information provided is correct. StudentAgree Date Father/StepfatherAgree Date Spouse (Student's)Agree Date Mother/StepmotherAgree Date Submit * Required