Cc Form 228 R PDF Details

If you are a taxpayer who is subject to backup withholding, then you will want to be sure to file form CC-Form-228 R. This form is used to report and claim credit for backup withholding that was taken out of your taxable income. The deadline for filing this form is April 15th of the year following the calendar year in which the backup withholding occurred. So, if you had backup withholding in 2017, you would need to file this form by April 15th, 2018. Filing this form can help ensure that you receive the proper credit for the taxes that were withheld from your income.

QuestionAnswer
Form NameCc Form 228 R
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescc form 228, fillable 228 fillable, cc form 228 r, 228 r

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APPENDIX - F

 

 

 

FINANCIAL STATEMENT

 

For use of this form see, CC Pam 145-6, proponent agency is ATCC-PC

 

 

 

DATA REQUIRED BY THE PRIVACY ACT OF 1974

Authority

10 USC 2101, 2103, 2104, 2111 and 5 usc 301.2

Principal Purpose

To obtain financial data in order to show financial solvency while participating in the Senior ROTC program.

Routine Use(s)

To provide information concerning a cadet's/applicant's financial status while participating in the Senior ROTC program.

Disclosure

Disclosure is voluntary. However, failure to provide complete information and provide responses may result in a

 

disapproval of the requested action.

 

 

 

PART I - PERSONAL DATA

1.NAME (Last, First, MI):

1a. SSN (Last 4 digits)

PART II - ASSETS

Enter the dollar amount (round any cents to whole dollars) beside each item that applies.

2. SAVINGS (Savings Account, Money Market Account, IRA)

3. BONDS, STOCKS (Investments)

4. COLLEGE TRUST

5. MOTOR VEHICLES (No Lein-Holder)

6. OTHER (i.e., Motorcycle, Rental Property)

7. TOTAL ASSETS

PART III - COLLEGE LIABILITIES

Enter the dollar amount (round any cents to whole dollars) beside each item that applies.

8. RENT/MORTGAGE (Apartment/House)

8a. LIVE WITH PARENTS/FAMILY (Enter an amount if thtere is a cost) (NOTE: If item 8 or 8a is $0 explain why):

9. UTILITIES (Electric, Water, Telephone, Cable, Gas)

10. MONTHLY FOOD EXPENSE

11. MEDICAL EXPENSE (Outstanding Medical Bills)

12. MONTHLY CLOTHING EXPENSE

13. INSURANCE (Life, Medical)

14. INSURANCE (Auto, Motorcycle, Home, Renters)

15. CAR OPERATING EXPENSES (Maintenance)

16. CAR PAYMENT

17. TOTAL LOANS/DEBITS (Outstanding Bills, VISA, Credit Cards)

18. MISCELLANEOUS EXPENSES (i.e. Entertainment)

19. CHILD SUPPORT (Dependent child under age 18)

20. OTHER

21. TOTAL MONTHLY DEBTS

PART IV - INCOME UPON ENTRY INTO THE ARMY ROTC PROGRAM (GROSS MONTHLY)

22. FREE ROOM & BOARD

 

 

 

 

 

 

 

 

 

23. SCHOLARSHIP (Other than ROTC)

 

 

(Check the appropriate box)

Yes

No

 

 

 

 

 

 

24. WORK STUDY

 

 

 

25. SCHOLARSHIP (ROTC)

 

 

26. STUDENT LOANS

 

 

 

27. STIPEND

 

 

 

 

 

 

 

28.APPLICANT SALARY

 

 

 

29. MGIB CHAPTER 30

 

 

 

 

 

 

 

30. SPOUSE SALARY

 

 

 

31. ADDITIONAL MGIB

 

 

 

 

 

 

 

32. GRANTS

 

 

 

33. ARMY COLLEGE FUND

 

 

 

 

 

 

 

34. PLUS +

 

 

 

35. TOTAL MONTHLY INCOME

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT'S SIGNATURE

 

 

 

COMMANDER'S SIGNATURE

 

 

 

 

 

 

 

CC FORM 228-R, AUG 2005

 

PREVIOUS EDITIONS ARE OBSOLETE

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Simple tips to complete appendix financial statement stage 1

2. After this section is complete, you should add the necessary particulars in CAR OPERATING EXPENSES Maintenance, CAR PAYMENT, TOTAL LOANSDEBITS Outstanding, MISCELLANEOUS EXPENSES ie, CHILD SUPPORT Dependent child, OTHER, TOTAL MONTHLY DEBTS, PART IV INCOME UPON ENTRY INTO, FREE ROOM BOARD Check the, STUDENT LOANS, APPLICANT SALARY, SPOUSE SALARY, GRANTS, PLUS APPLICANTS SIGNATURE, and Yes allowing you to progress to the third part.

Filling in part 2 in appendix financial statement

As to Yes and MISCELLANEOUS EXPENSES ie, ensure you take another look in this current part. Both these are thought to be the most significant fields in this document.

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