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||1Payments received for qualified Tuition and related expenses||2021||Tuition
|2Amount billed for qualified Tuition and related expenses|
|FILER's Federal identification no.||STUDENT'S taxpayer identification no.||3If this box is checked, your educational institution changed its reporting method for 2021|
|STUDENT'S name||4Adjustments made for a prior year||5Scholarships or grants|
|Street Address (including Apt. no.)||6Adjustments to scholarships or grants for a prior year||7Checked if the amount in box 1 or 2 includes amounts for an academic period beginning January-March 2022|
|City or town, state or province, country and ZIP or foreign postal code|
|Service Provider/Acct. No.||8Check if at least half-time student||9Check if a graduate student||10[blank]|