Fillable 1314DVFElectronic Form Distributed

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1314DVFElectronic Form Distributed

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U.S.A. forms for Orange County Community College

BROWSE ORANGE COUNTY COMMUNITY COLLEGE FORMS

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E-mailPhone Format: XXXXXXXXXX
SSN Format: XXXXXXXXX
Date of Birth
Last NameMIFirst Name
ID # (MUST start with A)
DVF 1314 DEPENDENT VERIFICATION FORM (V1& V5)
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
SUNY OrangeSelf
B. DEPENDENT STUDENT'S FAMILY INFORMATION
List the people in your household below:
Include: Yourself
Your parent(s) /step-parent
Children, if any, that your parent(s) / step-parent will provide more than half of their support from July 1, 2013, through June 30, 2014,
or if the child would be required to provide your parent(s) / step-parent information if they were completing a FAFSA for 2013 -2014.
Include children who meet either of these standards, even if they do not live with you.
Other people if they now live with you and your parent(s) / step-parent provides more than half of their support and will continue to
provide more than half of their support through June 30, 2014.
If anyone listed below will be enrolled at least half time, in a degree, diploma, or certificate program at a postsecondary educational institution any
time between July 1, 2013, and June 30, 2014 you MUST include the name of the college he/she is attending.
Full Name Age Relationship College 6+credits
(see drop down menu) (drop down )
If yes, I certify that I paid child support in 2012. I have listed below the names of the persons to whom the child support was paid, the names of the
children for whom the child support was paid and the total amount of child support paid in 2012 for each child. I also attest that I have not included these
children as members of my household size. (Parents can either include these children as members of the household *or* include the amount of child
support paid but may not include these children as members of the household and also list child support paid.
Name who paid the child support Name who received the support For whom support was paid Yearly amount paid
Did the parent (and, if married, the parent's spouse) pay child support in 2012? (See drop down menu for options)
Did someone in the household (listed in Section B) 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. NON-TAXABLE INCOME INFORMATION TO BE VERIFIED
Complete the section below ONLY if you were employed in 2012 AND DID NOT file a 2012 tax return.
You MUST provide documentation of all monies earned (e.g. copy of W-2).
Employer's Name Total Amount Earned in 2012 Received a W-2
I, the student.... (See drop down menu for options)
IMPORTANT INFORMATION: If you filed, or will file, an amended 2012 IRS tax return, you must contact your financial aid administrator before
completing this section.
The best way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA online. If you have not already used the tool, go to
FAFSA.gov, log in to your FAFSA record, select “Make FAFSA Corrections,” and navigate to the Financial Information section of the form. From there,
follow the instructions to determine if you are eligible to use the IRS Data Retrieval Tool to transfer 2012 IRS income tax information into your FAFSA. It
takes up to two weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and up to eight
weeks for paper IRS tax return filers. If you need more information about when, or how to use the IRS Data Retrieval Tool see your financial aid
Did you file / will file a 2012 tax return? (See drop down menu for options)
D. DEPENDENT STUDENT'S TAX INFORMATION TO BE VERIFIED
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)
F. 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.
Complete the section below ONLY if the parent (and, if married, the parent's spouse) were employed in 2012 AND DID NOT file a 2012 tax return.
You MUST provide documentation of all monies earned (e.g. copy of W-2).
Employer's Name Total Amount Earned in 2012 Received a W-2
I, the parent (and, if married, the parent's spouse).... (See drop down menu for options)
IMPORTANT INFORMATION: If the parent (and, if married, the parent's spouse) filed, or will file, an amended 2012 IRS tax return, you must contact
your financial aid administrator before completing this section.
The best way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA online. If you have not already used the tool, go to
FAFSA.gov, log in to your FAFSA record, select “Make FAFSA Corrections,” and navigate to the Financial Information section of the form. From there,
follow the instructions to determine if you are eligible to use the IRS Data Retrieval Tool to transfer 2012 IRS income tax information into your FAFSA. It
takes up to two weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and up to eight
weeks for paper IRS tax return filers. If you need more information about when, or how to use the IRS Data Retrieval Tool see your financial aid
administrator.
Did the parent (and if married, the parent's spouse) file / will file a 2012 tax return? (See drop down menu for options)
E. DEPENDENT PARENT'S TAX INFORMATION TO BE VERIFIED
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.
Office Use Only
Submitted Notified N/A Submitted Notified N/A
Initials: SNAP SW2
CSP MW2
STT PW2
PTT DAVD
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Completed 18 February 2020

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