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Family Financial Statement
Family Financial Statement
Award Letter Evaluation
C.V. Starr
Scholarship Program 2022
Family Financial Statement & Award Letter Summary
Check if this form is being completed by noncustodial parent
Date
Email that is checked regularly
Student Last Name
Student First Name
Parent 1:
First and last name/current age
Parent 2:First and last name/current age
Marital status of natural parents
-Please Select
Single - Never Married
Married
Separated
Divorced
One or both deceased
Please list names and ages of siblings in household
Sibling 1-Name/Age
Sibling 2-Name/Age
Sibling 3-Name/Age
Number of full time students in college in 2022-23
Estimated
student income
during summer 2022
Student's
current savings/investments (not 529s)
Year/Make/Model of Student Vehicle
Parent 1: Amount in Box 1
on 2021 Form W-2
Parent 1: Amount in Box 3
on 2021 Form W-2
Parent 2: Amount in Box 1
on 2021 Form W-2
Parent 2: Amount in Box 3
on 2021 Form W-2
Is either parent currently unemployed?
-Please Select
Yes
No
Is either parent sel-employed?
-Please Select
Yes
No
If yes, enter
net business income
for 2021 here
Current savings and checking account value
Non-retirement investment accounts
529 & Coverdell college savings accounts
If you rent your home, check this box
Current market value of home
Total
amount owed on home
Current market value of any other real estate
Total amount owed on other real estate
Paying For College Next Year
Note - you will have a better idea of how to answer these questions AFTER completing the Award Letter Evaluation Form.
Click on that tab in upper left corner of page.
Amount you expect to spend on college from income in Year 1
Amount you expect to spend on college from savings Yr 1
Amount you expect to borrow for college Yr 1
Amount from student savings
Yr 1
Amount you expect to receive from others for college
Total resources available for Year 1
If selected, amount of CV Starr Scholarship you are requesting
Anything you would like to add?
Any special circumstances?
CV Starr 2022 Award Letter Summary
List up to eight colleges.
Please enter first choice college at top.
Name of College
Total Cost of Attendance
Grants & Scholarships
Estimated VSAC Grant
Student Loan: Subsidized
Student Loan: Unsubsidized
First Year Cost
Available Resources
Funding Gap
Click Submit below to complete the process.
You will receive an acknowledgement and a copy of this form by email.
Thanks.
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