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.
Enter Full NameID # (MUST start with A)
I Accept
D. CERTIFICATIONS AND SIGNATURES
Electronic Signature Agreement. By providing your full student ID # below and by selecting the "I Accept" button, you are signing this
Agreement electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this Verification
Form. By selecting "I Accept" you consent that all of the information reported is complete and correct. You further agree that your
use of a key pad, mouse or other device to select an item, button, icon or similar act/action, constitutes your signature (hereafter
referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing.
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 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 (and spouse, if married).... See drop down menu for options.
IMPORTANT INFORMATION: If you (or your spouse, if married) 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.
Office Use Only
Submitted Notified N/A
SNAP
Initials: CSP
Transcript
Student W-2
Spouse W-2
ISEP
