Office Use Only
Financial Aid
File Reviewer
20172018 V5 Complete Verification
Independent Student
This form must be submitted in person to the One Stop in Building 22.
Your 20172018 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Verification. The law
states that before awarding Federal Student Aid, we must ask you to confirm the information you reported on your FAFSA. To verify
that you provided correct information, the Student Financial Services Office will compare your FAFSA with the information on this
worksheet and with any other required documents. If there are differences, your FAFSA information 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
One Stop in Building 22 at South Puget Sound Community College. Student Financial Services may ask for additional information. If
you have questions about Verification, contact Student Financial Services at (360) 596-5252 as soon as possible so that your financial
aid will not be delayed.
DO NOT LEAVE BLANK- READ AND COMPLETE ALL SECTIONS!
1. Student Information
Last Name First Name M.I. SSN
Email Phone SID
2. Household Information
Please complete the table below, include:
Yourself
Your spouse, if you are married.
Other people if they now live with you and you provide
more than half of their support and will continue to
provide more than half of their support through June 30,
2018.
Your children, if any, if you will provide more than half
of their support from July 1, 2017 through June 30,
2018.
Include the name of the college for any household
member, who will be enrolled, at least half time in a
degree, diploma, or certificate program at a
postsecondary educational institution any time between
July 1, 2017 and June 30, 2018. If more space is needed,
attach a separate page with the student’s name and
Social Security Number at the top
Full Name
Age
Relationship
College (if applicable)
self
South Puget Sound Community College
3. 2015 Income Information
Instructions for 2015 Tax Filers: Complete this section if the student or spouse filed a 2015 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 2015 income information that was transferred into
the student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.
The student/spouse used the IRS Data Retrieval Tool (DRT) on my FAFSA and did not alter the information.
The student/spouse have corrected my FAFSA and used the DRT. Please attach a copy of the FAFSA Confirmation page.
The student/spouse is unable or choose not to use the IRS DRT, and instead am providing a 2015 IRS Tax Transcript. See Step 4
for options on requesting your 2015 IRS Tax Transcript.
The student was selected for verification for 2016-2017 and previously submitted the student/spouse 2015 TRS Tax Transcript to
SPSCC Financial Aid Office. SPSCC Financial Aid is able to use the previously submitted 2015 Tax Transcript for 2017-2018
applications.
Instructions for 2015 Non-tax Filers: Complete this section if the student or spouse (if married) will not file and are not
required to file a 2015 income tax return with the IRS. Non-tax Filers are required to provide a Signed Statement of Non-
filing. See Step 4 for the requirements of a Statement of Non-filing for 2015.
The student/spouse did not file a 2015 Tax Return and had no income from work in 2015 and I am providing a signed statement of
Non-filing for 2015.
The student/spouse did not file a 2015 Tax Return and I was employed in 2015. I have listed all employer(s) and income earned
below AND attach W-2 form(s). I am also providing a signed statement of Non-filing for 2015.
Employer’s Name
Earnings/Income in 2015
2015 W-2 Form Provided
4. IRS Tax Transcript or Verification of Non-filing Letter Request Options
Get Transcript by MAIL Go to www.irs.gov, under the Tools heading, click "Get a tax transcript.” Click “Get
Transcript by MAIL.” Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account
Transcript.”
Get Transcript ONLINE Go to www.irs.gov
, under the Tools heading, click "Get a tax transcript." Click “Get
Transcript ONLINE.” Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account
Transcript.”
Attach a Signed Statement indicating that you were not required to file taxes and explain why. Please include how
you supported yourself and your dependents on $0.00 income for the period of January 1, 2015 December 31, 2016
and currently. Follow up clarification may be required.
5. High School Completion Status
Yes, I have a high school diploma, GED or have completed my homeschooling requirements and I’m submitting the following
documentation:
I have previously submitted documentation to the One Stop at SPSCC
Official High School Transcript
Copy of High School Diploma
Academic Transcripts (if student completed at least 2-years towards a Bachelor’s Degree)
Secondary School Leaving Certificate If completed Secondary Education in a Foreign Country
State Certificate or Transcript (GED, HiSET, TASC or other Statue Exam)
Letter from school district confirming homeschooling requirements met
No, I do not have a high school diploma or GED, nor have I completed homeschooling requirements.
6. Educational Purpose
The student must appear in person at South Puget Sound Community College to verify their identity by presenting an
unexpired valid government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued
ID, or passport. The institution will maintain a copy of the student’s photo ID that is annotated by the institution with the
date it was received and reviewed, and the name of the official at the institution authorized to receive and review the
student’s ID.
In addition, the student must sign, in the presence of the institutional official, the Statement of Educational Purpose provided
below.
Statement of Educational Purpose
I certify that I, am the individual signing this statement of
Educational Purpose and that the federal student financial assistance I may receive will only be used for
educational purposes and to pay the cost of attending South Puget Sound Community College for 2017-2018.
Student Signature Date
OFFICIAL OFFICE USE ONLY
ID TYPE Driver License Passport State ID Military Other
STAFF ID
7. Certification and Signature
The student (and parent if student is dependent) must sign and
date this worksheet. By signing, you certify that all of the
information reported on this worksheet is complete and correct.
Student’s Signature Date
Parent’s Signature (if dependent student only) Date
Do not mail this worksheet to the U.S. Department of Education.
THIS FORM MUST BE SUBMITED IN PERSON to the One Stop in Building 22 at South Puget Sound Community College.
South Puget Sound Community College
Student Financial Services
2011 Mottman Road SW
Olympia, WA 98512
Phone: (360) 596-5252
WARNING: If you purposely give false or misleading
information on this worksheet, you may be fined, be
sentenced to jail, or both.
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