Fillable 1819V1 Dependent (Jacksonville University)

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1819V1 Dependent (Jacksonville University)

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U.S.A. forms for Jacksonville University

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2800 University Boulevard N | Jacksonville, FL 32211
T 800.558.3467 | F 904.256.7148 Page 1 of 3
2018-19 V1 Standard Verification - Dependent
___________________________________________ ______________________________
Student’s Last Name First Name M.I. Student’s Identification (ID) Number
___________________________________________ ______________________________
Student’s Street Address (include apt. no.) Student’s Date of Birth
___________________________________________ ______________________________
City State Zip Code Student’s Email Address
___________________________________________ ______________________________
Student’s Home Phone Number (include area code) Student’s Alternate or Cell Number
Number of Household Members and Number in College
List below the people in your household. Include:
• Yourself as the student.
• The parents (including a stepparent) even if the student doesn’t live with the parents.
• The parents’ other children if the parents will provide more than half of their support from July 1,
2018, through June 30, 2019, or if the other children would be required to provide parental
information if they were completing a FAFSA for 2018-2019. Include children who meet either of
these standards even if the children do not live with the parents.
• Other people if they now live with the parents and the parents provide more than half of their support
and will continue to provide more than half of their support through June 30, 2019.
Number in College
: Include below information about any household member, 24 or under, who will be
enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary
educational institution any time between July 1, 2018 and June 30, 2019, include the name of the college.
If more space is needed, provide a separate page that includes the student’s name and ID number at the top.
Full Name
Age
Relationship
College
Will be
Enrolled at
Least Half
Time
(YES or NO)
Self
Jacksonville University
Parent
NA
NA
Note: We may require additional documentation if we have reason to believe that the information regarding
the household members enrolled in eligible postsecondary educational institutions is inaccurate.
Page 2 of 3
Verification of 2016 Income Information for Student
Complete part A if you filed a 2016 tax return; complete part B if you did not file a tax return.
A. Tax Return Filers
Important Note: The instructions below apply to the student.
Instructions: Complete this section if the student filed
a 2016 IRS income tax return. The best way to verify
income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the Web at FAFSA.gov.
In most cases, no further documentation is needed to verify 2016 income information that was transferred
into the student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.
Check the box that applies:
The student has used
the IRS DRT in FAFSA on the Web to transfer 2016 IRS income tax return
information into the student’s FAFSA.
The student has provided the school a 2016 IRS Tax Return Transcript(s).
http://www.irs.gov/Individuals/Get-Transcript
A 2016 IRS Tax Return Transcript may be obtained through:
• Get Transcript by MAIL – Go to www.irs.gov
, under the Tools heading, click "Get a tax
transcript.” Click “Get Transcript by MAIL.” Make sure to request the “IRS Tax Return
Transcript” and NOT the “IRS Tax Account Transcript.”
• Automated Telephone Request – 1-800-908-9946
• Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T
In most cases, for electronic tax return filers, 2016 IRS income tax return information is available for
the IRS DRT or the IRS Tax Return Transcript within 2–3 weeks after the 2016 electronic IRS income
tax return has been accepted by the IRS. Generally, for filers of 2016 paper IRS income tax returns,
the 2016 IRS income tax return information is available for the IRS DRT or the IRS Tax Return
Transcript within 6–8 weeks after the 2016 paper IRS income tax return has been received by the IRS.
Contact the financial aid office if more information is needed about using the IRS DRT or obtaining an
IRS Tax Return Transcript.
B. Non-filers
The instructions and certifications below apply to the student. Complete this section if the student will not
file and is not required to file a 2016 income tax return with the IRS.
Note: If amount earned from work is greater than $10,350 then you are required to file and must submit an
IRS Tax Return Transcript or use the IRS Data Retrieval link in your FAFSA. For more information on tax
filing requirements, visit www.irs.gov/publications/p17/.
Check the box that applies:
The student was not employed and had no income earned from work in 2016.
The student was employed in 2016 and has listed on the next page the names of all employers, the
amount earned from each employer in 2016, and whether an IRS W-2 form is provided. [Provide
Page 3 of 3
copies of all 2016 IRS W-2 forms issued to the student by their employers]. List every employer
even if the employer did not issue an IRS W-2 form.
If more space is needed, provide a separate page with the student’s name and ID number at the top.
Employer’s Name
2016 Amount
Earned
IRS W-2 Provided?
Suzy’s Auto Body Shop (example)
$2,000
Yes
Certifications and Signatures
Each person signing below certifies that all of the
information reported is complete and correct.
The student and one parent whose information was
reported on the FAFSA must sign and date.
___________________________________________ _________________________
Print Student’s Name Student’s ID Number
__________________________________________ _________________________
Student’s Signature Date
Save the completed form and return as an email attachment to the appropriate financial aid counselor listed
below:
• Online students and Speech Pathology students:
Brooke Sellars bsellar@ju.edu
• Students utilizing Veterans’ benefits:
Kerry Boggus kboggus@ju.edu
All other students are sorted by last name.
• Students Last Names A – Ge
Sherry Bruggemann sbrugge@ju.edu
• Students Last Names Gh – N
Rob Lowman rlowman@ju.edu
• Students Last Names O – Z
Misty Pippin mpippin1@ju.edu
or misleading information you may be
fined, be sentenced to jail, or both.
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1819V1 Dependent (Jacksonville University)

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Completed 21 July 2020

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