Debt Reduction Grant Step 1 of 4 - Personal Information 25% Personal InformationName First Last Gender Male Female Social Security #Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneBirth Date MM slash DD slash YYYY Marital Status Married Single Number of DependentsPlease select the number of your dependents01234567891011121314151617181920DependentsPlease list the names and ages for each of your dependents.NameAge Add Remove School and Student Loan InformationSeminaries Attended (list present school first)SchoolDates AttendedGPAYear Add RemoveScholarshipsPlease list any scholarships received while in seminary.Scholarship NameAmount ReceivedYear Add RemoveHonors and AwardsBriefly list any academic honors or rewards received while in seminary.Student LoansList student loans received while in seminary.Loan NameAmountYearCurrent Balance Add RemovePre-Seminary Loans(Required)Do you have any pre-seminary student loans? Yes No List Preexisting LoansPlease list any preexisting loans.InstitutionDateLoan AmountCurrent Balance Add Remove Personal FinancesApplicant Current Annual Income(Required)Please enter your current annual income:Spouse's Current Annual IncomeIf married, please enter your spouse's annual income:Car LoanDo you have automobile loan payments? Yes No Automobile Loan Payment AmountPlease enter the total per month payment amount for your automobile loan(s).Home MortgageDo you have home mortgage payments? Yes No Home Mortgage Payment AmountPlease enter the total per month payment amount for your mortgage(s). File Uploads & CertificationPlease include the following files:Income Tax Return from Loan Year(s)Copy of income tax return(s) for the year(s) in which you incurred loan debt while in seminary. (file size limited to 200mb)Accepted file types: pdf, doc, jpg, png, pages, Max. file size: 50 MB.Most Recent Tax ReturnCopy of your most recent tax return (max upload size 200mb)Accepted file types: pdf, doc, jpg, png, pages, Max. file size: 50 MB.Transcript(s)Copy of seminary transcript(s) (max upload size 200mb)Accepted file types: pdf, doc, jpg, png, pages, Max. file size: 50 MB.Student Loan StatementsCopy of your most recent student loan statements (max upload size 200mb)Accepted file types: pdf, doc, jpg, png, pages, Max. file size: 50 MB.Certification(Required) I certify that, to the best of my knowledge, the information contained in this application is correct and complete.Signature(Required)Please enter your full name. Signature Date(Required) MM slash DD slash YYYY Δ
