Fillable 2014 15 Dep V6 Worksheet (Golden Gate University)

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2014 15 Dep V6 Worksheet (Golden Gate University)

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2014–2015 Verification W
o
r
ksh
ee
t
Dependent Student - Tracking Group V
6
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
C. Supplemental Nutrition Assistance Program (SNAP)
Check the appropriate box below:
No one listed in the household received SNAP benefits in 2012 or 2013.
One of the persons listed in 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.
1
Student Name:
Student ID Number:
______________________________ __________________________
D. 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
E. 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.
To obtain a 2013 IRS Tax Return Transcript, go to www.IRS.gov and click on the “Get Transcript 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(s) is provided.
Check here if a 2013 IRS Tax Return Transcript(s) will be provided later.
2. TAX RETURN NONFILERS
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
2
Student Name:
Student ID Number:
______________________________ __________________________
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
F. 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 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
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 parent(s) was not employed and had no income earned from work in 2013.
The 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.
3
Student Name:
Student ID Number:
______________________________ __________________________
Employer’s
Na
me 2013 Amount Earned For Whom? IRS W-2 Attached?
Pro Auto $980 Father Yes
G. Other Untaxed Income
Complete this section if you or your parents had untaxed income in 2013.
If any Item does not apply enter “N/A” where a response is requested or enter “0” if an amount is requested.
Name of Person Who had Untaxed Income
Type of Untaxed Income Received
Student Amount
Parent
Amount
Jim Jones (example)
Money received or paid on the students behalf
$500.00
0
Payments to tax-deferred pension and savings plans
Housing, food, and other living allowances paid to
members of the military, clergy
Veterans noneducation benefits
Money received or paid on the students behalf
Other untaxed income
Other Untaxed Income includes: Untaxed income not reported elsewhere on this form, workers’ compensation, disability, black lung benefits,
untaxed portions of health savings accounts from IRS Form 1040 line 25, railroad retirement benefits etc.
Do Not include: student aid, earned income credit, additional child tax credit, TANF, untaxed social security benefits, SSI, WIA, combat pay,
benefits from flexible spending arrangements, foreign income exclusion or credit for federal tax on special fuels.
H. Child Support Received
Complete this section if child support was received in 2013 for any children listed in your household.
Name of Person Who Received Child
Support
Name of Child for Whom Support Was
Paid
Amount of Child Support Received in 2013
Joe Jones
Jim Jones
$5,000
Do not include foster care payments, adoption payments or any amount that was court ordered but not actually paid.
I. 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.
4
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Completed 20 July 2020

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