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)
B. Receipt of SNAP Benefits
Did any member of the parent(s)’ household receive benefits from the Supplemental Nutrition Assistance Program or SNAP (formerly known as
the Food Stamp Program) sometime during 2013 or 2014? SNAP may be known by another name in some states. For assistance in determining the
name used in a state, please call 1-800-4FED-AID (1-800-433-3243).
The parents’ household includes:
► The student and parents (including a stepparent) even if the student doesn’t live with the parents and
► The parents’ other children if the parents will provide more than half of their support from July 1, 2015, through June 30, 2016, or if the other
children would be required to provide parental information if they were completing a FAFSA for 2015–2016. Include children who meet either
of these standards even if the children do not live with the parents and
► Other people if they now live with the parents and the parents provide more than half of their support and will continue to provide more than
half of their support through June 30, 2016
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, 2013
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 the receipt of SNAP benefits and/or payment of child support is inaccurate, we
may require further documentation.
D. 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
