Financial Information Form

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EOP Financial Information

The information you provide here will be used in the review of your eligibility for the Educational Opportunity Program It is to your advantage to provide as much information as possible. If you leave any field incomplete it can jeopardize your application.

Section 1. Personal Information

First Name

Last Name

Address:

City:

State:

Zip:

e.g. 9999999999

Date of Birth

Applicant ID Number

High School CEEB Code

Entry Term

Are you a US citizen?

Section 2. Exceptions to Income Guidelines

Answer all of the questions below to help determine if you qualify for exclusion from the income eligibility guidelines.

Are you or your family primarily dependent on public assistance payments from Temporary Assistance to Needy Families (i.e. Family Assistance, Safety Net, cash grants received from public assistance)?

Are you in foster care as established by the court?

Are you a ward of the court or county?

If you answered yes to either of the last two questions above, skip to Section 8.

All others, continue to Section 3.

Section 3. Dependent Status

Answer all of the questions below to help determine your dependency status.

Were you born before January 1, 1998?

As of today, are you married? (Also answer yes if you are separated, but not divorced.)

Are you currently serving on active duty in the S.S. Armed Forces for purposes other than training?

Are you a veteran of the U.S. Armed Forces?

Do you now have or will you have children who will receive more than half of their support from you between July 1, 2021 and June 30, 2022?

Do you have dependents (other than your chldren or spouse) who live with you and who receive more than half of their support from you, now and through June 30, 2022?

At any time since you turned age 13, were both of your parents deceased, were you in foster care or were you a dependent or ward of the court?

As determined by a court in New York State, are you or were you an emancipated minor?

Does someone other than your parent or stepparent have legal guardianship of you, as determined by a court in your state of legal residence?

At any time on or after July 1, 2020, did your high school or school district homeless liaison determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless?

At any time on or after July 1, 2020 did the director of an emergency shelter or transitional housing program funded by the U.S. Department of Housing and Urban Development determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless?

At any time on or after July 1, 2020, did the director of a runaway or homeless youth basic center or transitional living program determine that you were an unaccompanied youth who was homeless or were elf-supporting and at risk of being homeless?

If you answered no to all of the questions above, your status is "Dependent" for the purposes of this form. Continue to Section 4.
If you answered yes to any of the questions above, your status is "Independent" for the purposes of this form. Skip to Section 5.

Section 4. Parent Information - FOR DEPENDENT STUDENTS ONLY

Dependent students must complete this section. Independent students should leave this section blank. For the purposes of this form, "legal parent" means your (biological or adoptive) parent, or a person that the state has determined to be your legal parent. Grandparents, foster parents, stepparents, legal guardians, widowed stepparents, aunts, uncles and siblings are not considered legal parents on this form unless they have legally adopted you.

What are the names of your legal parents (biological or adoptive)?

Legal Parent 1:

Legal Parent 2:

What is the relationship of your legal parents to each other?

If your legal parents were married to each other at one time, provide the month and year they were married, separated, divorced or widowed from each other.

If your legal parents are married to each other, or are not married but living together, skip to the last question in this section.

If your legal parents are not married to each other and do not live together, which parent did you live with more during the past 12 months?

Is the legal parent identified in the last questions above currently married or remarried?

Complete for special circumstances only: If you did not live with either of your legal parents during the past 12 months, with whom did you live? Please provide their names and relationship to you.

Section 5. Household Information

Provide the following information for all household members.
Dependent students: include yourself, the parent(s) with whom you live, your stepparent if applicable, their other dependent children (even if they do not live with you) if your parent(s) provide more than half of their support and your parent(s) will continue to provide more than half of their support between July 1, 2021 and June 30, 2022.

Note to students not living with a parent: Under very limited circumstance (for example, your parents are incarcerated; you have left home due to an abusive family environment; or you do not know where your parents are and are unable to contact them), you may be able to submit your SUNY EOP Financial Information Form without parental information. Contact the EOP Office at OCC for further instructions.

Independent Students: Include yourself, your spouse (if married), your children (if any) if you will provide half of their support between July 1, 2021 and June 30, 2022, even if they do not live with you, and other people if they now live with you, you provide more than half of their support and you will continue to provide more than half of their support between July 1, 2021 and June 30, 2022.

If there are more than 6 members in your household, include them in the extended answer box after these questions with the same information for each additional person in your household.

Additional Household Members

Section 6. Additional Household Income

Report all additional income received in your household for the tax year 2019.
If the answer is zero or the question does not apply to you, enter 0.

Dividends, interest, or other income from investments:

Social Services/Public Assistance (TANF, etc.):

Social Security Benefits:

Supplemental Security Income (SSI):

Workers Compensation/Disability:

Pension/Annuity:

Unemployment:

Veterans Noneducation Benefits:

Alimony/Maintenance:

Child Support:

Other income, including money received or paid on your behalf, e.g. bills, not reported elsewhere on this form. This includes money that you received from a parent or other person whose financial information is or reported above and that is not part of a legal child support agreement:

Section 7. Household Assets

Report the current value of the following assets held by your household. Independent students are not required to report information regarding assets held by parents. If the answer is zero or th question does not apply to you, enter 0.

Your cash, checking, and savings accounts:

Your investments (non-retirement):

Your trust fund/settlement:

Spouse's cash, checking, and savings accounts:

Spouse's investments (non-retirement):

Spouse's trust fund/settlement:

First parent's cash, checking, and savings accounts:

First parent's investments (non-retirement):

Second parent's or stepparent's cash, checking, and savings accounts:

Second parent's or stepparent's investments (non-retirement):

Asset Category

Purchase Year

Purchase Price

Current Value

Current Debt

Monthly Mortgage Payment

Business or farm owned by you, your spouse, or your parent(s)

Home owned by you, your spouse, or your parent(s)

Other real estate owned by you, your spouse, or your parent(s)

Section 8. Other Information

Please indicate if you currently participate in any of the following programs:

Educational Opportunity Center (EOC)

Early College, Middle College, or Gateway to College

GEAR-UP

STEP

Talent Search

Liberty Partnership

UpwardBound

TRIO

Have you filed for FAFSA?

Have you applied for TAP?

Section 9. Certification

I understand that I must be academically and economically eligible for EOP and that I must provide the required documentation with this form to prove my eligibility. I understand that I am required to file for the 2021-22 Free Application for Federal Student Aid (FAFSA) as soon as possible after October 1, 2020. I understand that additional paperwork may also be required.

All information submitted is true to the best of my knowledge. I understand that any knowing falsification or omission of data may result in the denial of admission or dismissal.

Your Initials

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If you have additional files that you need to submit beyond what is allotted on this form, please contact the EOP office via email eopoffice@sunyocc.edu or by calling 315-498-2428.

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