California Lutheran University – Office of Financial Aid
Dependent Verification Worksheet
Federal Student Aid Programs
Your 2015–2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. 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 Office of Financial Aid. We may ask for additional information. Should you require further instructions, please
contact our office at (805) 493-3115 or finaid@callutheran.edu.
CLU ID # or Social Security Number
Current phone number (include area code)
One of the parents included in the household or the student paid child support in 2014. List 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 of the
children for whom the child support was paid, and the total annual amount of child support that was paid in 2014 for
each child.
Name of person who made child support
payment(s)
Name of person who received child
support payment(s)
Name of child for whom
child support was paid
Total amount paid between
January 1 – December 31, 2014
If more space is needed, provide a separate page with the student’s name and ID number at the top.
Note: If we have reason to believe that the information regarding child support paid is not accurate, we may require
additional documentation, such as:
- A copy of the separation agreement or divorce decree that shows the amount of child support to be provided;
- A statement from the individual receiving the child support certifying the amount of child support received; or
- Copies of the child support payment checks or money order receipts.
C. Certifications and Signatures
Each person signing below certifies that all of the information reported is complete and correct. The student and one
parent whose information is reported on the FAFSA must sign and date. WARNING: If you purposely give false or
misleading information you may be fined, be sentenced to jail, or both.
CLU Office of Financial Aid
60 West Olsen Road #1375
Thousand Oaks, CA 91360
EMAIL: finaid@callutheran.edu
FAX: (805) 493-3114
Student’s Signature – Required
Parent’s Signature – Required
