2015–2016 Verification W
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Independent Student - Tracking Group V
3
Your 2015–2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. Before awarding Federal
Student Aid, you must confirm the information you and your spouse (if married) reported on your FAFSA. We will compare your FAFSA with the
information on this worksheet and with any other required documents. If there are differences, your FAFSA informatio
n 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 office. Additional information maybe required to resolve conflicting information.
A. Independent Student’s Information
Student’s SSN or ID Number
Student’s Street Address (include apt. no.)
Student’s Alternate or Cell Phone Number
B. Child Support Paid
Check the appropriate box below:
No child support was paid for individuals outside of the household in 2014.
The student and/or spouse, who is a member of the student’s household, paid child support in 2014. Provide in the space below the names
of the persons who paid the child support, the names of the persons to whom the child support was paid, the names and ages of the
children for whom child support was paid, and the total annual amount of child support that was paid in 2014 for each child. Do not include
child support paid for children included in the student’s household.
If more space is needed, provide a separate page that includes the student’s name and ID number at the top.
Name of Person Who P
aid
Child
Suppo
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t
Name of Person to W
ho
m
Child Support was P
aid
Name of Child for Whom
Suppo
r
t
Was P
aid
Support was Pad
Amount of Child
Suppo
r
t Paid in 2014
Note: If we have reason to believe that the information regarding child support paid is inaccurate, we may require additional documentation, such
as:
• A signed statement from the individual receiving the child support certifying the amount of child support received; or
• Copies of the child support payment checks, money order receipts, or similar records of electronic payment having been made.
C. Certification and Signature
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 must sign and date this form.
Spouse’s Signature (optional)
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.