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2013–2014 Verification Worksheet
Independent Student- Tracking Group V3
Your 2013–2014 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, the financial aid administrator at your school will compare your FAFSA with the information on this worksheet and with
any other required documents. If there are differences, your FAFSA information may need to be corrected. You must complete and sign this
worksheet, attach any required documents, and submit the form and other required documents to the financial aid administrator at your
school. Your school may ask for additional information. If you have questions about verification, contact your financial aid administrator as soon
as possible so that your financial aid will not be delayed.
A. Independent Student’s Information
Student’s Last Name Student’s First Name Student’s M.I.
Student’s SSN or 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 Phone Number
B. Independent Student’s Other Information to Be Verified
Complete this section if you and/or your spouse paid child support in 2012.
Either I, or if married my spouse, paid child support in 2012. I have indicated below the name of the person who paid the child
support, the name of the person to whom the child support was paid, the names of the children for whom child support was paid, and
the total annual amount of child support that was paid in 2012 for each child. If asked by my school, I will provide documentation
of the payment of child support. If you need more space, attach a separate page that includes your name and Social Security Number
at the top.
Name of Person Who Paid
Child Support
Name of Person to Whom
Child Support was Paid
Name of Child for Whom Support
Was Paid
Amount of Child Support
Paid in 2012
Joe Jones Jane Doe Jake Jones $6,000
C. Certification and Signatures
I certify that all of the information reported on this worksheet is complete and correct. The student must sign and date this worksheet. If
married, the spouse’s signature is optional.
Student’s Signature Date
Spouse’s Signature Date
Do not mail this worksheet to the U.S. Department of Education. Submit this worksheet to the financial aid
administrator at your school. You should make a copy of this worksheet for your records.
WARNING: If you purposely give false or misleading Information on this
worksheet, you may be fined, be sentenced to jail, or both.
