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| Assumed fields, based on the data you entered, are marked with an '*' (asterisk) sign. |
| Student ID | 291884680 YB |
|
| Step 1. (Q1 - Q35) |
| Last Name | YBALLE |
| First Name, Middle Initial | RAECHELLE C |
| Permanent Street Address | 2125 BRANDYWINE DR. |
| City | EUCLID |
| State Abbreviation, ZIP Code | OH 44143 |
| Social Security Number | 291884680 |
| Date of Birth | 09/19/1973 |
| Permanent Home Phone Number | 2164040622 |
| Driver's License Number | RT657318 |
| Driver's License State Abbreviation | OH |
| Citizenship Status | U.S. CITIZEN (OR U.S. NATIONAL) |
| Alien Registration Number | |
| Marital Status | SINGLE, DIVORCED, OR WIDOWED |
| Date of Marital Status | |
| Summer Term 2001 | FULL TIME/NOT SURE |
| Fall Term 2001 | FULL TIME/NOT SURE |
| Winter Term 2001-2002 | FULL TIME/NOT SURE |
| Spring Term 2002 | FULL TIME/NOT SURE |
| Summer Term 2002 | FULL TIME/NOT SURE |
| Father's Education Level | COLLEGE OR BEYOND |
| Mother's Education Level | COLLEGE OR BEYOND |
| State of Legal Residence Abbreviation | OH |
| Legal Resident Before 1/1/96? | NO |
| Date you became a legal resident | 07 1997 |
| Are you male? | NO |
| Register you with Selective Service | |
| Type of Degree/Certificate | GRADUATE/PROFESSIONAL DEGREE |
| Grade Level in College in 2001-2002 | CONTINUING GRADUATE/PROFESSIONAL OR BEYOND |
| HS Diploma or GED? | YES |
| First Bachelor's Degree by 7-1-2001 | YES |
| Interested in Student Loans? | YES |
| Interested in Work-Study? | YES |
| Drug Conviction Affecting Eligibility? | NO |
|
| Step 2. (Q36 - Q51) |
| Completed 2000 Income Tax Return | WILL FILE |
| Type of 2000 Tax Form Used | IRS 1040EZ |
| Eligible to file a 1040A/EZ? | |
| Student's Adjusted Gross Income from IRS Form | $9721 |
| Student's U.S. Income Tax Paid | $672 |
| Student's Exemptions Claimed | 1 |
| Student's Income Earned from Work | $9719 |
| Spouse's Income Earned from Work | |
| Student's Amount from Worksheet A | $50 |
| Student's Amount from Worksheet B | $0 |
| Student's Amount from Worksheet C | $0 |
| Student's Net Worth of Investments | $0 |
| Student's Net Worth of Bus and/or Inv Farms | $0 |
| Student's Cash, Savings, and Checking | $3000 |
| How many Months Receive VA Benefits? | |
| Monthly VA Benefits Amount | |
|
| Step 3. (Q52 - Q58) |
| Born before 1-1-78? | YES |
| Working on Masters or Doctorate Program? | YES |
| Are You Married? | NO |
| Children Who Receive Support? | NO |
| Have Dependents Other than Children or Spouse? | NO |
| Orphan or Ward of the Court? | NO |
| Veteran of U.S. Armed Forces? | NO |
|
| Step 4. (Q59 - Q83) |
| Parent(s) Marital Status | |
| Your Father's/Stepfather's Social Security Number | |
| Your Father's/Stepfather's Last Name | |
| Your Mother's/Stepmother's Social Security Number | |
| Your Mother's/Stepmother's Last Name | |
| Parent(s) Number of Family Members in 2001-2002 | |
| Parent(s) Number in College in 2001-2002 | |
| Parent(s) State Legal Residence | |
| Parent(s) Legal Resident Before 1-1-96? | |
| Date Parent(s) Became Legal Resident | |
| Age of older Parent | |
| Completed 2000 Income Tax Return | |
| Eligible to file a 1040A/EZ? | |
| Parent(s) Adjusted Gross Income from IRS Form | |
| Parent(s) U.S. Income Tax Paid | |
| Parent(s) Exemptions Claimed | |
| Father's Income Earned from Work | |
| Mother's Income Earned from Work | |
| Parent(s) Amount from Worksheet A | $0 |
| Parent(s) Amount from Worksheet B | $0 |
| Parent(s) Amount from Worksheet C | $0 |
| Parent(s) Net Worth of Investments | |
| Parent(s) Net Worth of Bus and/or Inv Farms | |
| Parent(s) Cash, Savings, and Checking | |
|
| Step 5. (Q84 - Q85) |
| Student's Number of Family Members in 2001-2002 | 1 |
| Student's Number in College in 2001-2002 | 1 |
|
| Step 6. (Q86 - Q97) |
| College 1 | GONZAGA UNIVERSITY (003778) |
| Housing 1 | |
| College 2 | UNIVERSITY OF AKRON (003123) |
| Housing 2 | |
| College 3 | LEWIS & CLARK COLLEGE (003197) |
| Housing 3 | |
| College 4 | CASE WESTERN RESERVE UNIV - LAW (E00082) |
| Housing 4 | |
| College 5 | VILLANOVA UNIV SCH OF LAW (E00428) |
| Housing 5 | |
| College 6 | CATHOLIC UNIV AMERICA, LAW SCHOOL (E00131) |
| Housing 6 | |
|
| Step 7. (Q98 - Q102) |
| Preparer's Social Security Number | |
| Preparer's EIN | |
| |
| Student E-mail Address | RCY1@UAKRON.EDU |
|
| Intermediate Worksheet Values |
| Worksheet A | Student(44) / Parent(s)(78) |
| Earned Income Credit | 50 / |
| Additional Child Tax Credit | / |
| Welfare Benefits | / |
| Untaxed Social Security Benefits | / |
| TOTAL | 50 / 0 |
|
| Worksheet B | Student(45) / Parent(s)(79) |
| Payments to Tax-Deferred Pensions & Savings | / |
| Deductible IRA/Keogh Payments | / |
| Child Support Received | / |
| Tax Exempt Interest Income | / |
| Foreign Income Exclusion | / |
| Untaxed Portions of Pensions | / |
| Credit for Federal Tax on Special Fuels | / |
| Housing, Food, & Living Allowances | / |
| Veterans Non-Education Benefits | / |
| Other Untaxed Income or Benefits | / |
| Cash Received (not reported elsewhere) | / XXXXX |
| TOTAL | 0 / 0 |
|
| Worksheet C | Student(46) / Parent(s)(80) |
| Education Credits | / |
| Child Support Paid | / |
| Taxable Work-Study Earnings | / |
| Grant and Scholarship Aid (reported in AGI) | / |
| TOTAL | 0 / 0 |
|
| Question 35 Worksheet |
| Convicted of possession/sale? | NO |
| All convictions removed? | |
| Completed drug rehab? | |
| How many possession convictions? | |
| Date of possession conviction | |
| Date of last possession conviction | |
| How many sale convictions? | |
| Date of sale conviction | |
|
| Question 35 Return Value | NO |