2019-2020
CHILD SUPPORT PAID
VERIFICATION
Office of Financial Aid
CSP_20
Student name: _______________________________________ SCC ID #:____________________
This form is to be completed if the student, student’s spouse (if married), OR the student’s parent(s) (if dependent)
paid child support in 2017. Do not complete if child support was received by any member of the household.
WARNING: If you purposely give false or misleading information on this worksheet, you will be reported to the
Department of Education. You may be fined, sentenced to jail, or both.
A. Child Support Paid Verification Check one box below:
No child support was paid in 2017. Skip to section B.
Independent Student:
The student and/or spouse (if married) paid child support in 2017. Complete the chart and certification
below.
Dependent Student:
The student’s parent(s) paid child support in 2017. Complete the chart and certification below.
Name of person who
paid child support
Name of parent to whom
child support was paid
Name of child for whom
support was paid
Amount of child support
paid in 2017
Bill Jones (example) Sara Jones Nora Jones $6,000 per year
If more space is needed, please attach a separate page with the student’s name and SCC ID number at the top.
B. Certification and Signature(s)
By signing this form, you are certifying that all the information reported on this form is true and accurate to the best of
your knowledge.
______________________________________________________ _______________________
Student Signature Date
______________________________________________________ _______________________
Parent Signature (dependent students only) Date
Rev. 3/29/19
