Fillable 20-21 Standard Verification Worksheet FINAL 20-21 Standard Verification Worksheet

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20-21 Standard Verification Worksheet FINAL 20-21 Standard Verification Worksheet

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The 20-21 Standard Verification Worksheet FINAL 20-21 Standard Verification Worksheet form is 2 pages long and contains:

  • 2 signatures
  • 8 check-boxes
  • 32 other fields

Country of origin: US
File type: PDF

U.S.A. forms for California State University, San Bernardino

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Return to:
5500 University Parkway
San Bernardino, CA 92407
University Hall Room 150
Tel
: (909) 537-5227 Fax: (909) 537-7024
2020-2021 Standard Verification Worksheet – V1
Com
plete this verification form and submit it as soon as possible. The Office of Financial Aid and Scholarships cannot
determine your award without this information. Please complete ALL sections.
Name: Coyote ID:
Email: Phone:
Dependent Student*
List the people in your parent(s)’ household including:
Yourself.
Your parent(s) (including a stepparent) even if you
don’t
live with your parents.
Your parent’s other children, if (a) your parents will
provide more than half of their support from July 1,
2020, through June 30, 2021 (even if they do not live
with your parent(s) or (b) the children would be
required to provide parental information if they were
applying for Federal Student Aid.
Other people if they now live with your parents and
your parents provide more than half of their support
and will continue to provide more than half of their
support from July 1, 2020 through June 30, 2021.
*A student is dependent if he/she was required to provide
parental information on the FAFSA.
Independent Student**
List the people in your household including:
Yourself.
Your spouse, if married.
Your children, if (a) you will provide more than half of
their support from July 1, 2020 through June 30, 2021
(even
if they do not live with you), or (b) if the child
would be required to provide your information as the
parent if they were applying for Federal Student Aid.
Other people if they now live with you and you provide
more than half of their support and will continue to
provide more than half of their support from July 1,
2020, through June 30, 2021.
**A student is independent if he/she was not required to
provide parental information on the FAFSA.
Section A: Family Household Information
Full Name
Age
Relationship to Student
College
Self (student)
CSUSB
Note: Include the name of the college for any household member, excluding your parent(s), who will be enrolled at least half
time in a degree, diploma, or certificate program at a postsecondary educational institution any time between July 1, 2020
and June 30, 2021. If more space is needed, attach a separate page with your name and Student ID Number at the top.
Section B: Parent(s) 2018 Tax & Income Information (Check ONE box only):
Tax Filers
The IRS Data Retrieval Tool was used to transfer my income information to the FAFSA.
I hav
e attached a copy of my 2018 Federal Tax Transcript or 1040 Federal Tax Return and applicable
Schedules (1, 2 and/or 3). (https://www.irs.gov/individuals/get-transcript)
Non-File
rs
I will not and am not required to file a 2018 U.S. Income Tax Return and have attached all 2018 W-2
form(s) along with IRS form 4506-T (verification of non-filing) to confirm my non-filing status.
I was not employed and did not earn income in 2018 and have attached IRS form 4506-T (verification of
non-filing) to confirm my non-filing status
.
Section C: Student (and Spouse) 2018 Tax & Income Information (Check ONE box only)
Tax Filers
The IRS Data Retrieval Tool was used to transfer my income information to the FAFSA.
I have attached a copy
of my 2018 Federal Tax Transcript or 1040 Federal Tax Return and
applicable Schedules (1, 2 and/or 3). (https://www.irs.gov/individuals/get-transcript)
Non-File
rs
I will not and am not required to file a 2018 U.S. Income Tax Return and have attached all 2018 W-2
form(s). (Independent students are required to submit the IRS form 4506-T (verification of non-filing) to
confirm non-filing status).
I was not employed and did not earn income in 2018. (If you are an independent student you are
required to submit the IRS form 4506-T (verification of non-filing) to confirm non-filing status).
Section D: Certification and Signatures
Each person signing this worksheet certifies that all information reported is complete and correct. If
dependent, the student and one parent must sign and date.
Date:
Student Signature:
Parent’s Signature:
Date:
V1 Standard Verification
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20-21 Standard Verification Worksheet FINAL 20-21 Standard Verification Worksheet

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Completed 21 May 2020

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