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ProcessedInformationFAFSAontheWebFederalStudentAid

ProcessedInformation

20162017ElectronicStudentAidReport(SAR)

TheSARsummarizestheinformationyousubmittedonyour20162017FreeApplicationforFederalStudentAid(FAFSA).
ApplicationReceiptDate:
ProcessedDate:

02/17/2016
02/18/2016

XXXXX8793GO01
EFC:004187*
DRN:3863

CommentsAboutYourInformation

Learnaboutfederaltaxbenefitsforeducation,includingtheAmericanOpportunityTaxCredit(AOTC).
Basedontheinformationwehaveonrecordforyou,yourEFCis004187.YoumaybeeligibletoreceiveaFederalPellGrantandother
federalstudentaid.YourschoolwilluseyourEFCtodetermineyourfinancialaideligibilityforfederalgrants,loans,andworkstudy,and
possiblefundingfromyourstateandschool.
YourFAFSAhasbeenselectedforareviewprocesscalledverification.Yourschoolhastheauthoritytorequestcopiesofcertain
financialdocumentsfromyouandyourparent(s).
WehaveforwardedyournametoSelectiveServiceforregistration,asyourequested.Theywillprocessyourregistrationrequest30
dayspriortoyour18thbirthday.
ThereisalimittothetotalamountofFederalPellGrantsthatastudentmayreceive,whichistheequivalentof6schoolyears.Oncea
totalamountofPellGranteligibilityhasbeenreceived,astudentcannolongerreceivePellGrantaid.
WHATYOUMUSTDONOW(Usethechecklistbelowtomakesurethatallofyourissuesareresolved.)
Ifyourparentshavenowcompletedtheir2015taxreturn,youshouldcorrectyourinformationtoreflecttheincomeandtaxinformation
reportedontheirtaxreturn.Click'MakeFAFSACorrections'onthe'MyFAFSA'pagetomakethecorrection.Ifyourparentsfileda
federaltaxreturnwiththeIRS,theymaybeeligibletousetheIRSDataRetrievalTool,whichisthebestandeasiestwaytoprovide
accuratetaxinformation.Withjustafewsimplesteps,yourparentscanviewinformationfromtheirIRStaxreturnandtransferthat
informationdirectlyintoyourFAFSA.Ifyourparentshavenotyetcompletedtheirtaxreturn,youmustcorrectthisSARtoreflectthe
incomeandtaxinformationreportedontheirtaxreturnonceitisfiled.
Ifyouneedtomakecorrectionstoyourinformation,click'MakeFAFSACorrections'onthe'MyFAFSA'pageusingyourFSAID.Ifyou
needadditionalhelpwithyourSAR,contactyourschool'sfinancialaidofficeorclickthe'Help'iconontheFAFSAhomepage.Ifyour
mailingaddressoremailaddresschanges,youcanmakethecorrectiononline.
BasedonyourEFCof004187,youmaybeeligibletoreceiveaFederalPellGrantofupto$1,625forthe20162017schoolyear
providedyouhavenotmetorexceededthelifetimelimitestablishedfortheFederalPellGrantprogram.

FAFSAData

Assumedfields,basedonthedatayouentered,aremarkedwithan'*'(asterisk)sign.

1.Student'sLastName:

GOMEZ

2.Student'sFirstName:

EDWARDO

3.Student'sMiddleInitial:

4.Student'sPermanentMailingAddress:

4898SPINNINGWHEELDRIVE

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5.Student'sPermanentCity:

BRIGHTON

6.Student'sPermanentState:

CO

7.Student'sPermanentZIPCode:

80601

8.Student'sSocialSecurityNumber:

XXXXX8793

9.Student'sDateofBirth:

06/28/1998

10.Student'sTelephoneNumber:

(720)2339592

11.Student'sDriver'sLicenseNumber:

141710506

12.Student'sDriver'sLicenseState:

CO

13.Student'sEmailAddress:

edwardog68@gmail.com

14.Student'sCitizenshipStatus:

YES,IAMAU.S.CITIZEN(ORU.S.NATIONAL)

15.Student'sAlienRegistrationNumber:

16.Student'sMaritalStatus:

IAMSINGLE

17.Student'sMaritalStatusDate:

18.Student'sStateofLegalResidence:

CO

19.WasStudentaLegalResidentBeforeJanuary1,2011?

YES

20.Student'sLegalResidenceDate:

21.IstheStudentMaleorFemale?

MALE

22.RegisterStudentWithSelectiveServiceSystem?

REGISTERME

23.DrugConvictionAffectingEligibility?

ELIGIBLEFORAID

24.Parent1EducationalLevel:

MIDDLESCHOOL/JR.HIGH

25.Parent2EducationalLevel:

MIDDLESCHOOL/JR.HIGH

26.HighSchoolorEquivalentCompleted?

HIGHSCHOOLDIPLOMA

27a.Student'sHighSchoolName:

ACADEMYHIGHSCHOOL

27b.Student'sHighSchoolCity:

THORNTON

27c.Student'sHighSchoolState:

CO

28.FirstBachelor'sDegreebefore20162017School
Year?

NO

29.Student'sGradeLevelinCollegein20162017:

NEVERATTENDEDCOLLEGE/1STYR.

30.TypeofDegree/Certificate:

1STBACHELOR'SDEGREE

31.InterestedinWorkstudy?

YES

32.StudentFiled2015IncomeTaxReturn?

NOTGOINGTOFILE

33.Student'sTypeof2015TaxFormUsed:

34.Student's2015TaxReturnFilingStatus:

35.StudentEligibletoFilea1040Aor1040EZ?

36.Student's2015AdjustedGrossIncome:

37.Student's2015U.S.IncomeTaxPaid:

38.Student's2015ExemptionsClaimed:

39.Student's2015IncomeEarnedfromWork:

$6,733

40.Spouse's2015IncomeEarnedfromWork:

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41.Student'sTotalofCash,Savings,andChecking
Accounts:

$200

42.Student'sNetWorthofCurrentInvestments:

$0

43.Student'sNetWorthofBusinesses/InvestmentFarms:

$0

44a.Student'sEducationCredits:

44b.Student'sChildSupportPaid:

$0

44c.Student'sTaxableEarningsfromNeedBased
EmploymentPrograms:

$0

44d.Student'sCollegeGrantandScholarshipAidReported
inAGI:

$0

44e.Student'sTaxableCombatPayReportedinAGI:

$0

44f.Student'sCooperativeEducationEarnings:

$0

45a.Student'sPaymentstoTaxDeferredPensions&
RetirementSavings:

$0

45b.Student'sDeductiblePaymentstoIRA/Keogh/Other:

45c.Student'sChildSupportReceived:

$0

45d.Student'sTaxExemptInterestIncome:

45e.Student'sUntaxedPortionsofIRADistributions:

45f.Student'sUntaxedPortionsofPensions:

45g.Student'sHousing,Food,&LivingAllowances:

$0

45h.Student'sVeteransNoneducationBenefits:

$0

45i.Student'sOtherUntaxedIncomeorBenefits:

$0

45j.MoneyReceivedorPaidonStudent'sBehalf:

$0

46.StudentBornBeforeJanuary1,1993?

NO

47.IsStudentMarried?

NO

48.WorkingonMaster'sorDoctoratein20162017?

NO

49.IsStudentonActiveDutyinU.S.ArmedForces?

NO

50.IsStudentaVeteran?

NO

51.DoesStudentHaveChildrenHe/SheSupports?

NO

52.DoesStudentHaveDependentsOtherthan
Children/Spouse?

NO

53.ParentsDeceased?/StudentWardofCourt?/InFoster
Care?

NO

54.IsorWasStudentanEmancipatedMinor?

NO

55.IsorWasStudentinLegalGuardianship?

NO

56.IsStudentanUnaccompaniedHomelessYouthas
DeterminedbyHighSchool/HomelessLiaison?

NO

57.IsStudentanUnaccompaniedHomelessYouthas
DeterminedbyHUD?

NO

58.IsStudentanUnaccompaniedHomelessYouthas
DeterminedbyDirectorofHomelessYouthCenter?

NO

59.Parents'MaritalStatus:

DIVORCEDORSEPARATED

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60.Parents'MaritalStatusDate:

12/2009

61.Parent1(Father's/Mother's/Stepparent's)Social
SecurityNumber:

62.Parent1(Father's/Mother's/Stepparent's)LastName:

63.Parent1(Father's/Mother's/Stepparent's)FirstName
Initial:

64.Parent1(Father's/Mother's/Stepparent's)DateofBirth:

65.Parent2(Father's/Mother's/Stepparent's)Social
SecurityNumber:

XXXXX1118

66.Parent2(Father's/Mother's/Stepparent's)LastName:

OLGUIN

67.Parent2(Father's/Mother's/Stepparent's)FirstName
Initial:

68.Parent2(Father's/Mother's/Stepparent's)DateofBirth:

08/18/1982

69.Parents'EmailAddress:

yesi_olguin13@hotmail.com

70.Parents'StateofLegalResidence:

CO

71.WereParentsLegalResidentsBeforeJanuary1,
2011?

YES

72.Parents'LegalResidenceDate:

73.Parents'NumberofFamilyMembersin20162017:

74.Parents'NumberinCollegein20162017(Parents
Excluded):

75.ParentsReceivedSupplementalSecurityIncome?

76.ParentsReceivedSNAP?

77.ParentsReceivedFree/ReducedPriceLunch?

78.ParentsReceivedTANF?

79.ParentsReceivedWIC?

80.ParentsFiled2015IncomeTaxReturn?

WILLFILE

81.Parents'Typeof2015TaxFormUsed:

IRS1040

82.Parents'2015TaxReturnFilingStatus:

HEADOFHOUSEHOLD

83.ParentsEligibletoFilea1040Aor1040EZ?

DON'TKNOW

84.IsParentaDislocatedWorker?

NO

85.Parents'2015AdjustedGrossIncome:

$44,408

86.Parents'2015U.S.IncomeTaxPaid:

$2,466

87.Parents'2015ExemptionsClaimed:

88.Parent1(Father's/Mother's/Stepparent's)2015Income
EarnedfromWork:

89.Parent2(Father's/Mother's/Stepparent's)2015Income
EarnedfromWork:

$43,088

90.Parents'TotalofCash,Savings,andChecking
Accounts:

$500

91.Parents'NetWorthofCurrentInvestments:

$0

92.Parents'NetWorthofBusinesses/InvestmentFarms:

$0

93a.Parents'EducationCredits:

$0

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93b.Parents'ChildSupportPaid:

$0

93c.Parents'TaxableEarningsfromNeedBased
EmploymentPrograms:

$0

93d.Parents'CollegeGrantandScholarshipAidReported
inAGI:

$0

93e.Parents'TaxableCombatPayReportedinAGI:

$0

93f.Parents'CooperativeEducationEarnings:

$0

94a.Parents'PaymentstoTaxDeferredPensions&
RetirementSavings:

$0

94b.Parents'DeductiblePaymentstoIRA/Keogh/Other:

$0

94c.Parents'ChildSupportReceived:

$7,632

94d.Parents'TaxExemptInterestIncome:

$0

94e.Parents'UntaxedPortionsofIRADistributions:

$0

94f.Parents'UntaxedPortionsofPensions:

$0

94g.Parents'Housing,Food,&LivingAllowances:

$0

94h.Parents'VeteransNoneducationBenefits:

$0

94i.Parents'OtherUntaxedIncomeorBenefits:

$0

95.Student'sNumberofFamilyMembersin20162017:

96.Student'sNumberinCollegein20162017:

97.StudentReceivedSupplementalSecurityIncome?

98.StudentReceivedSNAP?

99.StudentReceivedFree/ReducedPriceLunch?

100.StudentReceivedTANF?

101.StudentReceivedWIC?

102.IsStudentorSpouseaDislocatedWorker?

103a.FirstFederalSchoolCode:

001350

103b.FirstHousingPlans:

ONCAMPUS

103c.SecondFederalSchoolCode:

002548

103d.SecondHousingPlans:

ONCAMPUS

103e.ThirdFederalSchoolCode:

001365

103f.ThirdHousingPlans:

ONCAMPUS

103g.FourthFederalSchoolCode:

004509

103h.FourthHousingPlans:

ONCAMPUS

103i.FifthFederalSchoolCode:

103j.FifthHousingPlans:

103k.SixthFederalSchoolCode:

103l.SixthHousingPlans:

103m.SeventhFederalSchoolCode:

103n.SeventhHousingPlans:

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103o.EighthFederalSchoolCode:

103p.EighthHousingPlans:

103q.NinthFederalSchoolCode:

103r.NinthHousingPlans:

103s.TenthFederalSchoolCode:

103t.TenthHousingPlans:

104.DateCompleted:

02/17/2016

105.SignedBy:

BOTHSTUDENTANDPARENT

106.Preparer'sSocialSecurityNumber:

107.Preparer'sEmployerIdentificationNumber(EIN):

108.Preparer'sSignature:

Graduation/Retention/TransferRates

CollegeRates

Thetableshowsthegraduation,retention,andtransferratesfortheschoolsyouselected.GototheCollegeNavigatorWebsitefor
completeinformation.

SchoolName
COLORADOSTATE
UNIVERSITY
HASTINGSCOLLEGE
COLORADOSTATE
UNIVERSITYPUEBLO
UNIVOFCOLORADOAT
COLOSPRINGS

Graduation
Rate

Retention
Rate

Transfer
Rate

AdditionalInformationfrom
CollegeNavigator

65%

85%

10%

N/A

59%

74%

N/A

N/A

32%

63%

15%

N/A

47%

66%

36%

N/A

YourFinancialAidHistoryInformation

Theinformationbelowisthetotalamountofstudentloansthatyouowe.TheseloansareadministeredbytheU.S.Departmentof
Education(ED).Youshouldconfirmthattheseloantotalsarecorrect.Youcanviewdetailsontheindividualloansthatmakeupthese
totalsattheNationalStudentLoanDataSystem(NSLDS)Website.Ifyoufeelthattheamountslistedonthispageareincorrect,oryou
haveotherquestionsrelatedtoaloan,youshouldcontacttheloanservicerindicatedontheNSLDSWebsite.Youcanobtaingeneral
informationabouteachofthetypesofloansthatarelistedbelowbyvisitingourStudentAid.govWebsite.

Notethatthe"Subsidized"and"Unsubsidized"amountsincludetheappropriateportionsofanyConsolidationLoansyoumayhave.If
thereisanamountlistedfor"UnallocatedConsolidationLoans"itisbecausewecouldnotdeterminewhetherthosebalanceswere
subsidizedorunsubsidized.

Rememberyouareresponsibleforrepayingalloftheamountsthatyouborrow,plusinterest.Asageneralrule,withanassumed
interestrateof5%,themonthlypaymentamountoveratenyearrepaymentperiodwouldbeapproximately$10.61forevery$1,000that
youborrowed.Ofcourseyouractualrepaymentamountwilldependuponhowmuchyouborrow,theinterestratewhenyouenter
repayment,andhowlongyourrepaymenttermis.
TotalAmountofLoansOutstanding
FFEL(BankLoans)and/orDirect
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TotalPrincipal

RemainingAmounttobe

Total
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Loans:

Balance

Disbursed

SubsidizedLoans:
UnsubsidizedLoans:
CombinedLoans:
UnallocatedConsolidationLoans:

FederalPerkinsLoanAmounts:
TotalOutstandingPrincipalBalance:
20162017LoanAmount:
TEACHGrantsConvertedtoDirect
Loans:
UnsubsidizedLoans:

Atthispoint,theschool(s)listedonyourapplicationhaveaccesstoyourinformation.Theschool(s)mayputtogetherorchangeanaid
packagebasedonyourExpectedFamilyContributionandnotifyyou.

Theamountofaidyoureceivefromaschoolwilldependonthecostofattendanceatthatschool,yourenrollmentstatus(fulltime,three
quartertime,halftime,orlessthanhalftime),Congressionalappropriations,andotherfactors.Reviewyourfinancialaidnotificationfrom
theschool(s)orcontacttheFinancialAidAdministratorattheschool(s).

Note:Yourschoolhastheauthoritytorequestcopiesofcertainfinancialdocumentstoverifyinformationyoureportedonyour
application.

Toprotecttheconfidentialityofyourapplicationdata,youshouldnevergive,share,ordiscloseyourFSAIDtoanyone,
includingcommercialserviceprovidersthatprovideassistancewiththefinancialaidprocess.YoushouldkeepyourFSAID
inasafelocation.

AccordingtothePaperworkReductionActof1995,nopersonsarerequiredtorespondtoacollectionofinformationunlesssuch
collectiondisplaysavalidOMBcontrolnumber.ThevalidOMBcontrolnumberforthisinformationcollectionis18450001.Public
reportingburdenforthiscollectionofinformationisestimatedtoaverage5to10minutesperresponse,includingtimeforreviewing
instructions,searchingexistingdatasources,gatheringandmaintainingthedataneeded,andcompletingandreviewingthecollectionof
information.Theobligationtorespondtothiscollectionisvoluntary.Ifyouhavecommentsorconcernsregardingthestatusofyour
individualsubmissionofthisform,pleasecontacttheFederalStudentAidInformationCenter,P.O.Box84,Washington,D.C.20044
directly.

Wemayrequestadditionalinformationfromyoutoprocessyourapplicationmoreefficiently.Wewillcollectthisadditionalinformationonly
asneededandonavoluntarybasis.

Byansweringquestions103athrough103t,andsigningtheFreeApplicationforFederalStudentAid,yougivepermissiontotheU.S.
DepartmentofEducationtoprovideinformationfromyourapplicationtothecollege(s)youentered.Youalsoagreethatsuchinformation
isdeemedtoincorporatebyreferencethecertificationstatementonthesignandsubmitpageofthefinancialaidapplication.The
certificationstatementcanbeviewedatwww.fafsa.gov/fotw1617/help/ffinal02a.htm.

WARNING:IfyouareconvictedofdrugdistributionorpossessionforanoffensethatoccurredwhileyouwerereceivingTitleIVaid,
youreligibilityforTitleIVstudentfinancialaidissubjecttosuspensionortermination.Ifyourdrugconvictionstatuschangesatanytime
duringthe20162017awardyear,youmustupdateyouranswertothedrugconvictionaffectingeligibilityquestion.

2010fafsa.gov.Allrightsreserved.
FAFSA,Arrowsymbol,andNSLDSaretrademarksoftheU.S.DepartmentofEducation

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