Skip to content. | Skip to navigation

Personal tools
Log in

Navigation

You are here: Home / Aid & the Bill / Verification Selections / Even Year Forms / Student Household
send
print
You must print this form. For best results use Firefox, Chrome, or Safari (if printing from Internet Explorer, deselect "shrink to fit" in the print preview panel).
upload
Then return it to us by upload, fax, or mail. Find out how
Penn State University, Student Aid visual mark
Office of Student Aid
The Pennsylvania State University
314 Shields Building
University Park, PA 16802-1220
(814) 865-6301
Fax: (814) 863-0322
studentaid.psu.edu

Student Household

We need to verify how many people will be in your household between July 1, 2017 and June 30, 2018. When reporting household size:

List the people for whom you (the student) and your spouse (if applicable) will provide more than 50 percent support between July 1, 2017 and June 30, 2018. Indicate if the person is attending college at least half-time in 2017-18 in a degree or certificate program. Attach a separate sheet if necessary.

1. Student/Spouse

Include yourself and your spouse, if you were married on or before the date you signed your FAFSA.

Full NameAgeRelationship to StudentName of College*Attending at Least Half-Time?(Y OR N**)
Student
Spouse

*Only list college for those who will be enrolled between July 1, 2017 & June 30, 2018. If they are undecided, list first choice college.

**Half-time is typically 6 credits for undergraduate students and 5 credits for graduate students. This information is for the 2017-18 academic year and the student must be in a program that leads to a degree or certificate.

2. Your Children

Include your children or your spouse's children if you (or your spouse) will provide more than half of the children's support from July 1, 2017 through June 30, 2018, even if the child does not live with you.

Children Information
Full NameAge (If 24 or older please also list in section 3)Relationship to StudentName of College*Attending at Least Half-Time?(Y OR N)**
Child
Child
Child

3. Others Living with You

List other people who live in the household, their relationship to the student, their age, and then list yes or no to indicate whether or not you and your spouse, if married, provide more support for each person than the combined total they receives from all of the following resources:

  • Work income (employment)
  • Financial aid, including loans
  • Government assistance (SNAP, SSI, federal housing)
  • Unemployment Compensation
  • Child Support / Foster Care Payments
  • Savings accounts
  • Social Security benefits
  • Interest income
  • Temporary Assistance for Needy Families
  • Welfare
  • Money from others
  • Worker's Compensation
  • Income from any other source

(Examples: student’s girlfriend, student’s boyfriend, family friend, aunt, grandparent, etc.)

Others' Information
Full Name of Household MemberAgeRelationship to StudentDoes this person receive more support from you/your spouse than he/she receives from all other sources listed above? (Y or N)Name of College*Attending at Least Half-Time? (Y or N)**
Handwritten student signature required
By signing this document, I certify that all the information reported on it and all enclosures are complete and correct to the best of my knowledge. If I purposely give false or misleading information on this document, it will be cause for denial or repayment of student aid and I may be fined, be sentenced to prison, or both.
Write student name and PSU ID on every page FESHH/2018