DESNAP 1314 DEPENDENT SNAP VERIFICATION FORM (V2)
Your 2013 -2014 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Verification. The law says before awarding Federal
Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify that you provided correct information the financial aid administrator at your
school will compare your FAFSA with the information on this worksheet and with any other required documents. If there are differences, your FAFSA information may
need to be corrected. You must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the financial aid
administrator at your school. Your school may ask for additional information. If you have questions about verification, contact your financial aid administrator as soon as
possible so your financial aid will not be delayed.
A. STUDENT INFORMATION
ID # (MUST start with A)
First Name MI Last Name
Phone Format: XXXXXXXXXX E-mail
SSN Format: XXXXXXXXX
Date of Birth
B. SNAP INCOME INFORMATION TO BE VERIFIED
Did someone in the household receive benefits from the Supplemental Nutrition Assistance Program/SNAP (formerly known as
food stamps) any time during the 2011 or 2012 calendar years? (
See drop down menu for options)
C. CERTIFICATIONS
Electronic Certification Agreement. By providing your full student ID # below and by selecting the "I Accept" button, you consent that all of the
information reported is complete and correct. You further agree that you will submit a Dependent Verification Worksheet Affidavit Signature Form, with
original signatures of BOTH the student and parent, for verification purposes.
WARNING: If you purposely give false or misleading information on the worksheet, you may be
fined, be sentenced to jail, or both.
To electronically submit this form you MUST use the "SUBMIT" button located at the top of this form.
You MUST have Adobe Reader 9 or higher to submit this form electronically.
If you DO NOT see a submit button in the top right of this form you will need to
To verify your form was properly submitted, allow 48 hours then check your "Financial Aid Status" in your Banner Self Service account.
Parent's Full Name
I Accept
Parent Certification:
Student's Full Name
ID # (MUST start with A)
I Accept
Student Certification:
You MUST submit a Dependent Verification Worksheet Affidavit Signature Form, with original signatures of BOTH the
student and parent, before your financial aid can be finalized.
(http://www.sunyorange.edu/financialaid/forms/docs/1213AFFIDAVITDVF_000.pdf)
Office Use Only
Submitted Notified N/A
Initials: SNAP
DAVD
