student financial services
20192020 DEPENDENT STANDARD
VERIFICATION WORKSHEET
Your 2019-2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law
says that 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, we will compare your FAFSA with the information on this institutional verification document
and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You and a
parent whose information was reported on the FAFSA must complete and sign this institutional verification document, attach any
required documents, and submit the form and other required documents to us. We may ask for additional information. If you have
questions about verification, contact us as soon as possible so that your financial aid will not be delayed.
Deadline: To determine your eligibility for federal and/or state funds, your verification documents must be received by our office
no later than August 14, 2020 or 120 days after your last date of enrollment, whichever comes first. Failure to do so by the stated
deadline will result in a loss of eligibility for the current academic year.
MTC must review the requested information, under the financial aid program rules (34 CFR, Part 668).
A. STUDENT INFORMATION
Print the information requested below:
Last Name First Name M.I. MTC ID
Address (include apt. no.) MyMTC Email Address
City State Zip Code Student Date of Birth
Student Home Phone Number (include area code) Student Alternate or Cell Phone (include area code)
B. FAMILY INFORMATION
List below the people in the parent’s household, include:
> The student
> The parents (including a stepparent) even if the student doesn’t live with the parents.
> The parent’s other children if the parents will provide more than half of the children’s support from July 1, 2019, through
June 30, 2020, or if the other children would be required to provide parental information if they were completing a FAFSA
for 2019-2020. Include children who meet either of these standards, even if a child does not live with the parents.
> Other people if they now live with the parents and the parents provide more than half of the other person’s support, and
will continue to provide more than half of that person’s support through June 30, 2020.
Number in college: Include in the space below information about any household member, excluding the parents, who is, or 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, 2019, and June 30, 2020, and include the name of the college.
If more space is needed, provide a separate page with the student’s name and ID number at the top.
Full Name Age Relationship* College Attending in 2019-2020 Will be enrolled at
least half time?
1. Self Midlands Technical College Yes/No
2.
3.
4.
5.
6.
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.
**If the relationship listed is not a parent, sibling or child, you must also complete Section D of the clarification statement explaining the
reason this individual should be included in your household size.
D1
C. DEPENDENT STUDENT AND PARENT INCOME TO BE VERIFIED
1. TAX RETURN FILERS complete this section if the student and/or parent(s) filed or will file a 2017 income tax return. The
best way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA on the Web at FAFSA.gov. In most cases,
no further documentation is needed to verify 2017 income information that was transferred into the student ‘s FAFSA using the
IRS DRT if that information was not changed.
Check the box that applies:
Students Parents
o
I have used the IRS Data Retrieval Tool in FAFSA on the web to transfer my 2017 income information
into the student’s FAFSA.
o
o
I am unable or choose not to use the IRS Data Retrieval Tool in FAFSA on the web, and I am submitting
to the school a signed copy of my 2017 Federal Tax Return Form (1040) or my 2017 IRS Tax Return
Transcript. (See below for instructions on how to request an IRS Tax Return Transcript.)
o
2. TAX RETURN NON–FILERS Complete this section If you, the student and/or parent, will not file and are not required to
file a 2017 income tax return with the IRS.
Check the box that applies:
Students Parents
o
Students: I was not employed in 2017 and had no income earned from work in 2017.
Parents: I was not employed and had no income earned from work in 2017. You must submit a
Verification of Non-filing letter from the IRS for the 2017 tax year dated October 1, 2018 or later.
o
o
I was employed in 2017 and have listed below the names of all employers, the amount earned from
each employer in 2017, and whether an IRS W-2 form is attached. Attach copies of all 2017 W-2 forms
issued to you by employers. List every employer even if the employer did not issue an IRS W-2 form.
If more space is needed, attach a separate page with your name and MTC ID at the top. You must
submit a Verification of Non-filing letter from the IRS for the 2017 tax year dated October 1, 2018
or later.
o
Employers’ Name (example: Suzy’s Auto Body Shop) 2017 Amount Earned (ex: $2,000.00) IRS W-2 Attached? (yes)
3. INCOME INFORMATION FOR INDIVIDUALS WITH EXTENUATING CIRCUMSTANCES
Check the box that applies:
Students Parents
o
I am required to file a 2017 IRS Tax Return and have been granted a filing extension by the IRS beyond
the automatic six month extension for tax year 2017. I have attached the following: a copy of IRS
Form 4868 “Application for Automatic Extension of Time to File US Individual Income Tax Return,
that was filed with the IRS for the tax year 2017, a copy of the IRS approval of an extension beyond
the automatic six month extension for tax year 2017, a Verification of Non Filing Letter dated on or
after October 1, 2018, and a W2 for each source of employment received for tax year 2017, or if self-
employed, a signed statement certifying the amount of the individual’s Adjusted Gross Income and US
income tax paid for tax year 2017.
o
o
I filed an amended IRS tax return for the tax year 2017 and I have attached the following: A 2017 Tax
Return Transcript, and a signed copy of the 2017 IRS Form 1040X (Amended US Individual Income Tax
Return that was filed with the IRS).
o
o
I am a Victim of IRS related identity theft and have attached the following: A Tax Return Database
View (TRDBV) transcript from the IRS that includes all of the income and tax information required to be
verified and a statement signed and dated indicating that I was a victim of IRS tax related identity theft
and that the IRS is aware of the tax related identity theft.
o
To obtain a 2017 IRS Tax Return Transcript you have the following options:
1. Get Transcript by Mail – Go to www.irs.gov, click “Get Your Tax Record.” Click “Get Transcript by Mail.” Make sure to
request the “Return Transcript” and NOT the “Account Transcript.” The transcript is generally received within 10 business
days from the IRS’ receipt of the online request.
2. Get Transcript Online – Go to www.irs.gov, click “Get Your Tax Record.” Click “Get Transcript Online.” Make sure to
request the “Return Transcript” and NOT the “Account Transcript.” To use the Get Transcript Online tool, the user must
have (1) access to a valid email address, (2) a text-enabled mobile phone (pay-as-you-go plans cannot be used) in the
user’s name, and (3) specific financial account numbers (such as a credit card number or an account number for a home
mortgage or auto loan). The transcript displays online upon successful completion of the IRS’ two-step authentication.
3. Automated Telephone Request – 1.800.908.9946. Transcript is generally received within 10 business days from the IRS’
receipt of the telephone request.
4. Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T . The transcript is generally received within 10 business
days from the IRS’ receipt of the paper request.
D. SIGN THIS WORKSHEET
I certify that all of the information reported is complete and correct. The student and one parent whose information was reported
on the FAFSA must sign this worksheet. WARNING: If you purposely give false or misleading information, you may be fined, be
sentenced to jail, or both.
Student’s Signature (Required) Date
Parent’s Signature (Required) Date
SD-19-5256O-02-19
Return completed form and all copies of requested documents to:
Student Financial Services Office
i
Midlands Technical College
i
PO Box 2408
i
Columbia, SC 29202
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