| # | Id | Type | Description |
| 1 | studentTinCertification | boolean | By checking the box in STUDENT'S TIN, filer is making a true and accurate certification under penalty of perjury that they have complied with standards promulgated by the Secretary for obtaining such individual's TIN |
| 2 | accountNumber | string | Account number |
| 3 | halfTime | boolean | Box 8, Check if at least half-time student |
| 4 | qualifiedTuitionFees | number | Box 1, Payments received for qualified tuition and related expenses |
| 5 | adjustmentPriorYear | number | Box 4, Adjustments made for a prior year |
| 6 | scholarship | number | Box 5, Scholarships or grants |
| 7 | adjustScholarship | number | Box 6, Adjustments to scholarships or grants for a prior year |
| 8 | includeJanMar | boolean | Box 7, Check if the amount in box 1 or box 2 includes amounts for an academic period beginning January - March of next year |
| 9 | graduate | boolean | Box 9, Check if graduate student |
| 10 | insuranceRefund | number | Box 10, Insurance contract reimbursement / refund |