CERTIFICATIONS AND SIGNATURES
Mail: Financial Aid Office
Eastern Wyoming College
3200 West C Street
Torrington, WY 82240
2014-2015
Independent V3 Verification
(Child Support Paid)
Your application has been selected for review in a process called “Verification”. In this process, the information from your Free
Application for Federal Student Aid (FAFSA) will be compared with your and your spouse’s (if applicable) actual information. If there
are differences, your FAFSA information may need to be corrected. You and your spouse (if applicable) must complete and sign this
worksheet and submit it to the Financial Aid Office at EWC.
______________________________________________________________ _________________________________________
Last Name First Name M.I. EWC Student ID Number
______________________________________________________________ _________________________________________
Address (include apartment number) Social Security Number (last four digits)
______________________________________________________________ _________________________________________
City, ST, Zip Phone Number (include area code)
Fill in the information below about the people you and your spouse (if applicable) will support between July 1, 2014 and June 30, 2015.
INCLUDE YOURSELF, YOUR SPOUSE (if applicable), YOUR CHILDREN AND ANY OTHERS
WHO RECEIVE MORE THAN
HALF OF THEIR SUPPORT FROM YOU. List the name of the college others will be attending if they are enrolled in a degree,
diploma, or certificate program for at least six credits per term between July 1, 2014 and June 30, 2015.
Full name of household member Age Relationship to student College attending
Self EWC
Did either you or your spouse (if applicable) PAY child support in 2013 for any children NOT listed above as a household member?
No Yes If “yes”, complete box below. If asked by my school, I will provide documentation of child support payment.
Name of person who
PAID child support
Name of person to whom
child support was paid
Name of child for whom
child support was paid
amount of child
By signing this worksheet, I/we certify that all of the information reported is complete and correct. I/we also acknowledge that I/we
have read and agree to comply with all verification policies as stated by EWC. Failure to submit information in a timely fashion
may result in the application being filed as inactive with no further consideration and no federal aid for the academic year. Student
and spouse (if applicable) must sign:
____________________________________________________ ___________________________________________________
Student’s signature Date Spouse’s signature Date
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
2/12/14
click to sign
signature
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signature
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