The Financial Data section of the application should be completed by the parent/guardian of a dependent child, or by the applicant if independent, or by the spouse or domestic partner of those persons who died or were permanently disabled. Information should be from a completed tax return or based on estimated information to be filed with the IRS/Revenue Canada. (This information is not applicable for non-U.S./Canadian residents. A separate financial data form will be provided to applicants outside the U.S and Canada.)

1. State/Province of Residence is the state/province where the parent/guardian, spouse, domestic partner or applicant reside and pay state/province income tax
2. Adjusted Gross Income can be found on IRS FORM 1040 and is gross income reduced by specific adjustments allowed by law. For Canadian applicants, report Taxable Income
3. Total U.S./Canadian Total Federal Tax Paid includes the total amount of federal income tax to be paid. This is not the amount withheld from employee’s paychecks. (The amount withheld should be adjusted by any refund or additional taxes due.) Do not report state/province income tax
4. Total Income earned should be reported individually for the parent/guardian, or spouse or domestic partner or for the applicant and spouse. Financial information must be received from the parent who claims the child as a dependent for tax purposes.
5. Untaxed Income and Benefits (For U.S. applicants only) include any other income or benefits not included in the adjusted gross income figure. Do not include untaxed contributions to retirement plans.
6. Medical and Dental Expenses include only those expenses not paid by insurance. Do not include premium payments.
7. Total Cash, Checking, Savings, Cash Value of Stocks, etc., include liquid assets that can be used for educational expenses. Include all funds received from insurance and September 11 settlements. Do not include IRA, 401k, RRSP, or other retirement plan funds.
8. Total Number of Family Members living in the household and primarily supported by the reported income may include:
• the applicant
• the applicant’s parents
• other children living in the household
• dependent college students living away from home
• other people who live in the household and receive more than half of their support from the reported income
9. Independent students should only report those individuals who are supported by the reported income.
10. Be sure to check the appropriate box giving the current marital status of the parent/guardian, spouse, domestic partner or applicant from whom the financial information is submitted.
11. Of the total number of family members, Number of Students Attending College includes family members attending a two- or four-year college, university, or vocational-technical school at least half-time. Include the applicant in this number. Do not include parents.

Note: Any exceptions to providing financial information as instructed above must be submitted to Scholarship America in writing.