C.V. Starr  Scholarships -  Confidential Financial Statement  
     
Date Form Completed
Student Last Name
Student First Name
Parent's relationship to student
Email that is checked regularly
Parent 1:  First and last name/current age
Parent 2:First and last name/current age
Please list names and ages of siblings in your household
Sibling 1-Name/Age
Sibling 2-Name/Age
Sibling 3-Name/Age
Number of full time students in college in 2024-25
Estimated student income during summer 2024
Student's current savings/investments (not 529s or Coverdell's)
Year/Make/Model of Student Vehicle
Parents Adjusted Gross Income on 2023 Form 1040
Parent 1: Amount in Box 1 on 2023 Form W-2 
Parent 1: Amount in Box 3 on 2023 Form W-2 
Parent 2: Amount in Box 1 on 2023 Form W-2 
Parent 2: Amount in Box 3 on 2023 Form W-2 
Is either parent currently unemployed?
Is either parent sel-employed?
If yes, enter net business income for 2023 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
  Please enter annual amounts you expect to spend next year    
Amount you expect to spend on college from parents income
Amount you expect to spend on college from parent savings
Amount parents expect to borrow for college
Amount you expect to spend on college from student savings
Amount you expect student to borrow for college
Amount you expect to receive from others for college
 
Anything you would like to add?  Any special circumstances?
  Proceed to Award Letters Page - Click Tab Above  
  Award Letter Evaluations        
  List up to eight colleges.  List your top choice first!      
  Click "Update" below if first year out of pocket cost and four year cost are not visible.  
  Click "Submit" below to complete the process.      
Name of College Total Cost of Attendance Grants & Scholarships Student Loan: Subsidized Student Loan: Unsubsidized College Work Study Estimated Out of Pocket Cost Yr 1 Estimated Four  Year Cost
 
Click Submit below to complete the process.
You will receive an acknowledgement and a copy of this form by email.  Thanks.