Click on a box number description for more information.
| Filer's name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number | 1 Payments received for qualified Tuition and related expenses | 2023 | Tuition Statement |
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| 2 Amount billed for qualified Tuition and related expenses | ||||||
| FILER's Federal identification no. | STUDENT'S taxpayer identification no. | 3 If this box is checked, your educational institution changed its reporting method for 2023 | ||||
| STUDENT'S name | 4 Adjustments made for a prior year | 5 Scholarships or grants | ||||
| Street Address (including Apt. no.) | 6 Adjustments to scholarships or grants for a prior year | 7 Checked if the amount in box 1 or 2 includes amounts for an academic period beginning January-March 2024 | ||||
| City or town, state or province, country and ZIP or foreign postal code | ||||||
| Service Provider/Acct. No. | 8 Check if at least half-time student | 9 Check if a graduate student | 10 [blank] | |||