Fillable 2014 15 Dep V5 Worksheet (Golden Gate University)

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2014 15 Dep V5 Worksheet (Golden Gate University)

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2014–2015 Verification W
o
r
ksh
ee
t
Dependent Student - Tracking Group V
5
Your 2014–2015 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 and your parents 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 inf
ormation may need to be corrected. You and at least one
parent 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. Dependent Student’s Information
Student’s Last Name
Student’s First Name
MI
Student’s SSN or ID Number
Student’s Date of Birth
City
State
Zip
Student’s Email Address
Student’s Phone Number
Student’s Alternate or Cell Phone Number
B. Dependent Student’s Family Information
Number of Household Members: List below the people in the parents’ household. Include:
The student.
The parents (including a stepparent) even if the student doesn’t live with the parents.
The parents’ other children if the parents will provide more than half of the children’s support from July 1, 2014, through June 30, 2015,
or if the other children would be required to provide parental information if they were completing a FAFSA for 2014–2015. Include
children who meet either of these standards even if the children do not live with the parents.
Other people if they now live with the parents and the parents provide more than half of the other people’s support and will continue to
provide more than half of their support through June 30, 2015.
Number in College: Include below information about any household member, excluding the parents, who 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, 2014, and June 30, 2015,
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
Na
me
Age
Relationship
C
olle
ge
Will be Enrolled
at
Least Half T
i
me
Missy Jones (example)
18
Sister
Central University
Yes
1
Student Name:
Student ID Number:
C. Dependent Student’s Income Information to Be Verified
1. TAX RETURN FILERS
Instructions: Complete this section if the student filed or will file a 2013 IRS income tax return. The best way to verify income is by using the
IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the Web at FAFSA.gov. In most cases, no further documentation is needed to verify
2013 income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed.
In most cases, for electronic tax return filers, 2013 IRS income tax return information for the IRS DRT is available within 2–3 weeks after the
2013 electronic IRS income tax return has been accepted by the IRS. Generally, for filers of 2013 paper IRS income tax returns, the 2013 IRS
income tax return information is available for the IRS DRT within 8–11 weeks after the 2013 paper IRS income tax return has been received
by the IRS. Contact the financial aid office if more information is needed about using the IRS DRT.
Check the box that applies:
The student has used the IRS DRT in FAFSA on the Web to transfer 2013 IRS income tax return information into the student’s FAFSA.
The student has not yet used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2013 IRS income tax return
information into the student’s FAFSA once the 2013 IRS income tax return has been filed.
The student is unable or chooses not to use the IRS DRT in FAFSA on the Web, and instead will provide the school a 2013 IRS Tax
Return Transcript(s).
To obtain a 2013 IRS Tax Return Transcript, go to www.IRS.gov and click on the “Get Transcripts for Your Tax Records” link. Make sure to
request the “IRS Tax Return Transcript” and not the “IRS Tax Account Transcript.” Use the Social Security Number (or the IRS individual
taxpayer identification number) and the date of birth of the first person listed on the 2013 IRS income tax return, and the address on file
with the IRS (normally this will be the address used on the 2013 IRS income tax return). In most cases, for electronic filers, a 2013 IRS Tax
Return Transcript may be requested from the IRS within 2–3 weeks after the 2013 IRS income tax return has been accepted by the IRS.
Generally, for filers of 2013 paper IRS income tax returns, the 2013 IRS Tax Return Transcript may be requested within 8–11 weeks after
the 2013 paper IRS income tax return has been received by the IRS.
Check here if a 2013 IRS Tax Return Transcript is provided.
Check here if a 2013 IRS Tax Return Transcript will be provided later.
2. TAX RETURN NONFILERS
Instructions: Complete this section if the student will not file and is not required to file a 2013 income tax return with the IRS.
Check the box that applies:
The student was not employed and had no income earned from work in 2013.
The student was employed in 2013 and has listed below the names of all the student’s employers, the amount earned from
each employer in 2013, and whether an IRS W-2 form is attached. Attach copies of all 2013 IRS W-2 forms issued to the student by
employers. List every employer even if they did not issue an IRS W-2 form. If more space is needed, attach a separate page with the
student’s name and Social Security Number at the top.
Employer’s
Na
me
2013 Amount
Earned
IRS W-2
Attached?
ABC Shipping (example)
$1,280
Yes
2
Student Name:
Student ID Number:
______________________________ __________________________
D. Parent’s Income Information to Be Verified
1. TAX RETURN FILERS
Important Note: The instructions below apply to each parent included in the household. Notify the financial aid office if the parents filed
separate IRS income tax returns for 2013 or had a change in marital status after the end of the 2013 tax year on December 31, 2013.
Instructions: Complete this section if the parents filed or will file a 2013 IRS income tax return(s). The best way to verify income is by using
the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the Web at FAFSA.gov. In most cases, no further documentation is needed to
verify 2013 income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed.
In most cases, for electronic tax return filers, 2013 IRS income tax return information for the IRS DRT is available within 2–3 weeks after the
2013 electronic IRS income tax return has been accepted by the IRS. Generally, for filers of 2013 paper IRS income tax returns, the 2013 IRS
income tax return information is available for the IRS DRT within 8–11 weeks after the 2013 paper IRS income tax return has been received
by the IRS. Contact the financial aid office if more information is needed about using the IRS DRT.
Check the box that applies:
The parents have used the IRS DRT in FAFSA on the Web to transfer 2013 IRS income tax return information into the student’s
FAFSA.
The parents have not yet used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2013 IRS income tax return
information into the student’s FAFSA once the 2013 IRS income tax return has been filed.
The parents are unable or choose not to use the IRS DRT in FAFSA on the Web, and instead will provide the school a 2013 IRS Tax
Return Transcript(s).
To obtain a 2013 IRS Tax Return Transcript, go to www.IRS.gov and click on the “Get Transcripts for Your Tax Records” link. Make sure to
request the “IRS Tax Return Transcript” and not the “IRS Tax Account Transcript.” Use the Social Security Number (or the IRS individual
taxpayer number) and the date of birth of the first person listed on the 2013 IRS income tax return, and the address on file with the IRS
(normally this will be the address used on the 2013 IRS income tax return). In most cases, for electronic filers, a 2013 IRS Tax Return
Transcript may be requested from the IRS within 2–3 weeks after the 2013 IRS income tax return has been accepted by the IRS. Generally,
for filers of 2013 paper IRS income tax returns, the 2013 IRS Tax Return Transcript may be requested within 8–11 weeks after the 2013
paper IRS income tax return has been received by the IRS.
If the parents filed separate 2013 IRS income tax returns, 2013 IRS Tax Return Transcripts must be provided for both.
Check the box that applies:
Check here if a 2013 IRS Tax Return Transcript(s) is provided.
Check here if a 2013 IRS Tax Return Transcript(s) will be provided later.
2. TAX RETURN NONFILERS
Instructions: Complete this section if the student’s parent(s) will not file and is not required to file a 2013 income tax return with the IRS.
Check the box that applies:
The student’s parent(s) was not employed and had no income earned from work in 2013.
The student’s parent(s) was employed in 2013 and has listed below the names of all the parent’s employers, the amount
earned from each employer in 2013, and whether an IRS W-2 form is attached. Attach copies of all 2013 IRS W-2 forms issued to
the parent(s) by employer(s). List every employer even if they did not issue an IRS W-2 form. If more space is needed, attach a
separate page with the student’s name and Social Security Number at the top.
Employer’s
Na
me 2013 Amount Earned For Whom? IRS W-2 Attached?
Pro Auto
$980
Father
Yes
3
Student Name:
Student ID Number:
______________________________ __________________________
E. Parent’s Other Information to Be Verified
1. SNAP Benefits, check the appropriate box below:
No one listed in the household received SNAP benefits in 2012 or 2013.
One of the persons listed in the household received SNAP benefits in 2012 or 2013. If asked by the student’s school, I will provide
documentation of the receipt of SNAP benefits during 2012 and/or 2013.
2. Child support paid, check the appropriate box below:
No child support was paid for individuals outside of the household in 2013.
One (or both) of the student’s parents listed in Section B of this worksheet paid child support in 2013. The parent has 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 2013 for each child. If
asked by the school, I will provide documentation of the payment of child support. If you need more space, a
ttach a separate page
that includes the student’s name and Social Security Number at the top.
Name of Person Who P
aid
Child
Suppo
r
t
Name of Person to W
ho
m
Child Support was P
aid
Name of Child for Whom
Suppo
r
t
Was P
aid
Amount of Child
Suppo
r
t
Paid in
2013
Joe Jones
Jane Doe
Jake Jones
$6,000
F. High School Completion Status
You must submit documentation of high school completion or an equivalent along with this worksheet.
Check the box of the document you will attach to this worksheet:
High school diploma or high school transcript including graduation date.
A copy of the student’s General Educational Development (GED) certificate, an official GED transcript that indicates the student passed
the exam, or a state-authorized high school equivalent certificate
For students who completed secondary education in a foreign country, a copy of the “secondary school leaving certificate” or other
similar document.
Academic transcript of a successfully completed two-year program acceptable for full credit toward a bachelor’s degree.
For a homeschooled student from a state where state law requires the student to obtain a secondary school completion credential for
homeschool (other than a high school diploma or its recognized equivalent), a copy of that credential.
For a homeschooled student from a state where state law does not require the student to obtain a secondary school completion
credential for homeschool (other than a high school diploma or its recognized equivalent), a transcript or the equivalent, signed by the
student's parent or guardian, that lists the secondary school courses the student completed and includes a statement that the student
successfully completed a secondary school education in a homeschool setting.
4
Student Name:
Student ID Number:
______________________________ __________________________
G. Documentation of Identity/Statement of Educational Purpose
In order to complete the Verification process, you will need to appear in person at your postsecondary institution and present your
government issued ID (such as a driver’s license, military ID, passport, etc.) and this verification worksheet to an institutionally authorized
financial aid administrator. Your financial aid administrator will need to validate the statement below at the time of submission by
maintaining a copy of your photo ID and by providing a signature and date. If you cannot appear in p
erson to submit this worksheet, you
will need to provide a copy of your government issued ID and this worksheet notarized by a public notary.
Statement of Educational Purpose
I certify that I
am the individual signing this Statement of Educational Purpose and that the
Printed Student’s Name
Federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending
for 2014-2015.
(Name of Postsecondary Educational Institution)
Student’s Signature
Date
Financial Aid Administrator’s Signature
Date
Notary’s Certificate of Knowledge
State of
City/County of
On
before me,
personally appeared,
(Notary’s Name) (printed name of signer)
And proved to me on basis of satisfactory evidence of identification
(Type of government-issued photo ID provided)
To be the above-named person who signed the foregoing instrument.
WITNESS my hand and official seal
(Notary Signature)
(Date Commission Expires)
(Seal)
H. Certification and Signatures
Each person signing this worksheet certifies that all of the information reported on it is complete and correct. WARNING: If you purposely give
false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
The student and one parent must sign and date.
Student’s Signature
Date
Parent’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.
5
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2014 15 Dep V5 Worksheet (Golden Gate University)

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Completed 20 July 2020

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