2018-2019 Dependent Verification Worksheet
Number of Household Members and Number in College: Include in the space below information about any household
member who is, or 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, 2018, and June 30, 2019, and 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
1. List below the people in the parents’ household. Include:
The student.
Indian Hills Community College
The parents (including a stepparent) even if the student doesn’t live with the parents.
College, If Will be Enrolled at Least Half Time
The parents’ other children if the parents will provide more than half of the children’s support from July 1, 2018,
through June 30, 2019, or if the other children would be required to provide parental information if they were
completing a FAFSA for 2018–2019. Include children who meet either of these standards, even if a child does not live
with the parents.
Include other people only if they now live with the parents and the parents provide more than half of the other person’s
support, and will continue to provide more than half of that person’s support through June 30, 2019. Support includes
money, housing, food, clothes, medical and dental care, gifts, loans, payment of college costs, etc.
College, If Will be Enrolled at Least Half Time
2. Did you attend a college other than IHCC during the 2018-19 school year?
3. Have you or will you be required to file a 2016 U.S. federal income tax return?
*Submit a Student NonTax Filer Form available on the WebAdvisor. Be sure to submit all 2016 W-2 and 2016 1099 forms you received.
4. Have your parent(s) filed or will they be required to file a 2016 U.S. federal income tax return?
Submit a Parent NonTax Filer Form available on the WebAdvisor. Be sure to submit all 2016 W-2 and 2016 1099 forms they received.
*Submit an IRS Verification of Non-filing Letter which you can request from the IRS at https://www.irs.gov/individuals/get-
transcript.
5. Certification and Signature
Each person signing below certifies that all of the information reported is complete
and correct (the student and at least one parent must sign). A hand written
signature, not typed, is required.
Student’s Signature (Required)
Parent’s Signature (Required)
Please return this completed form and all other required materials to:
Ottumwa Campus: Indian Hills Community College, Attn. Financial Aid, 525 Grandview Avenue, Ottumwa, Iowa 52501
Fax: 641-683-5741, Phone: 800-726-2585, ext. 5262 or 641-683-5262, Email: OneStop@indianhills.edu
Centerville Campus: Indian Hills Community College, 721 North First Street, Centerville, IA 52544
Fax: 641-856-3158, Phone: 800-670-3641, ext. 2200 or 641-856-2143, ext. 2200
To check the status of your documents, go to WebAdvisor and click the Financial Checklist, under the Financial Aid heading.
WARNING: If you purposely give false or
misleading information, you may be
fined, sent to prison, or both.
