CSS PROFILE Application Questions Quick Reference Chart

1 Page 1 of 2 DescriptionPROFILE Help Code1040 Line #1040A Line # 1040ez Line #Not Required To FileTotal Number of ExemptionsSI-1006d6dSee instructions for line 5-Adjusted Gross Income (AGI)SI-10537214-Income Tax PaidSI-110563910-EducationCredits(Americ anOpportunity,HopeandLifetimeLearning)SI -1155033--Itemized Deductions SI-120 Schedule A, Line 29---Student Income From WorkSI-1257 + 12 + 18+ Schedule K-1( form 1065), box 14If 12 & 18 are negative, treat them as (s) W-2 (boxes 1 and 8), pay stubs. Include wages received as household employee for which you did not receive a form W-2 Spouse Income From WorkSI-1307 + 12 + 18+ Schedule K-1 ( form 1065), box 14If 12 & 18 are negative, treat them as (s) W-2 (boxes 1 and 8), pay stubs. Include wages received as household employee for which you did not receive a form W-2 Interest & Dividend IncomeSI-1358a + 9a8a + 9a2 form 1099-INT, form 1099-DIV and Bank StatementsUntaxedSocialSecuritybenefitsr eceivedforindependent studentandotherfamilymembers( ,son,daughter,spouse& other dependents)SI-140(20a - 20b) + form SSA-1099 (Box 5)for all dependent children(14a -14b) + form SSA-1099 (Box 5) for all dependent childrenAdd all Forms SSA-1099 (Box 5)Add all Forms SSA-1099 (Box 5)Earned Income CreditSI-15566a42a8a-Other Untaxed IncomeSI-160 Paid Medical & Dental Expenses (not covered by insurance)SE-105 Schedule A, Line 1--Medical/Dental ReceiptsDescriptionPROFILE Help Code1040 Line #1040A Line # 1040ez Line #Not Required To FileTotal Number of ExemptionsPI-1006d6dSee instructions for line 5-Wages, Salaries & TipsPI-105771 form (s) W-2 (boxes 1 and 8)

2 , pay stubs. Interest IncomePI-1108a8a2 form 1099-INT and Bank StatementsDividend Income PI-1159a9a- form 1099-DIV and Bank StatementsNetincomeorlossfrombusiness,fa rm,rents,royalties,partnerships,estate,t rusts, loss,usea minus(-) + 17+ 18---Othertaxableincomereceivedsuchasali mony,capitalgainsorlosses,pensions,annui ties, loss,useaminus (-) + 11 + 13 + 14 + 15b + 16b +19 + 20b + 2110+ 11b + 12b + 13 + 14b3-Adjustments to Income PI-1303620--Adjusted Gross Income (AGI)PI-13537214-Income Tax PaidPI-140563910-EducationCredits(Americ anOpportunity,HopeandLifetimeLearning)PI -1455033--Itemized Deductions PI-150 Schedule A, line 29---Parent 1 Income From Work PI-1557 + 12 + 18+ Schedule K-1 ( form 1065), box 14If 12 & 18 are negative, treat them as (s) W-2 (boxes 1 and 8), pay stubs. Include wages received as household employee for which you did not receive a form W-2 Parent 2 Income From Work PI-1607 + 12 + 18+ Schedule K-1 ( form 1065), box 14If 12 & 18 are negative, treat them as (s) W-2 (boxes 1 and 8), pay stubs.

3 Include wages received as household employee for which you did not receive a form W-2 Untaxed Social Security benefits received for parents and dependent family members, EXCEPT for the (20a - 20b) + form SSA-1099 (Box 5) for all dependent children(14a -14b) + form SSA-1099 (Box 5) for all dependent childrenAdd all Forms SSA-1099 (Box 5)Add all Forms SSA-1099 (Box 5)Untaxed Retirement Payments(Deductible IRA and/or SEP, SIMPLE, or Keogh payments) PI-18528 + 3217--Untaxed IRA Distributions, excluding "rollovers"PI-18715a - 15b11a - 11b-Payments to Tax-Deferred Pension & Savings PlansPI-190 Untaxed portion of pensions received, excluding "rollovers"PI-19216a - 16b12a - 12b-Tuition & Fees DeductionPI-1953419--Health Savings AccountPI- 20225---Earned Income CreditPI-20566a42a8a-Additional Child Tax creditPI-2076743-Tax Exempt Interest Income PI-2158b8b- form 1099-INT (box 8) Foreign Income ExclusionPI-22021 (Coded " form 2555" or "2555-EZ")ORForm 2555, line 45 ORForm 2555EZ, line 18---Other Untaxed IncomePI-225 Paid Medical & Dental Expenses (not covered by insurance)PE-120 Schedule A, Line 1--Medical/Dental ReceiptsCSS PROFILE Application QuestionsQuick Reference ChartFinancial Aid & Scholarship Services (FASS)

4 N Ho'okama a PauahiAcademic Year 2016-2017 Student's 2015 Income and BenefitsParents' 2015 Income and BenefitsUse this Chart along with your completed 2015 federal income tax return and supporting documentation to answer the following Questions on the CSS PROFILE worksheet on page 2 See worksheet on page 2W2 form boxes 12a-12d, codes D, E, F, G, H, and S. Include untaxed payments to 401(k) and 403(b) 2 of 2 DescriptionAmount1040 Line #1040A Line # 1040ez Line #Not Required To FileTax Exempt Interest Income$8b8b- form 1099-INT (box 8) Untaxed IRA distributions, excluding "rollovers"$15a -15b11a -11b--Untaxed portion of pensions received, excluding "rollovers"$16a -16b12a -12b--Untaxed IRA Deduction(Deductible IRA and/or SEP, SIMPLE, or Keogh payments) $28+3217--Additional Child Tax credit$6743--Payments to Tax-Deferred Pension & Savings Plans$Worker's Compensation$Veteran's Educational Benefits$Veteran's Non-educational Benefits$Living Allowances$Cash received from relatives, friends, etc.

5 $UntaxedCombatPay(Fortaxfilers, ,alsoreportamountasearnings)$Other Untaxed Income$TOTAL OTHER UNTAXED INCOME (SI-160)$Worker's Compensation $Cash received from relatives, friends, etc. $Any untaxed military service benefits not reported elsewhereUntaxedCombatPay(Fortaxfilers, ,alsoreportamountasearnings)$Other Untaxed Income $TOTAL OTHER UNTAXED INCOME (PI-225)$Worker's compensation documentationCash received or any money paid on your behalf ( , bills) not reported elsewhere. Don't include child other untaxed income and benefits W-2 Box 12 Code QW-2 Box 12 Code QWorksheet for Student's 2015 Other Untaxed Income (SI-160)Worksheet for Parents' 2015 Other Untaxed Income (PI-225)Any other untaxed income and benefitsDisability, Death Pension, or Dependency & Indemnity Compensation (DIC), , food and other living allowances paid to members of the military, clergy and others (including cash payments and cash value benefits)Cash received or any money paid on your behalf ( , bills) not reported elsewhere.

6 Don't include child allowancesW2 form boxes 12a-12d, codes D, E, F, G, H, and S. Include untaxed payments to 401(k) and 403(b) 's compensation documentatio