1 CONTINUED ON REVERSE
2018-2019
Dependent Verification Worksheet (DV1/DV5)
Your 2018-2019 FAFSA was selected for review in a process called verification. Federal law states that we have the right to confirm
the information that was reported before awarding and/or disbursing federal student aid. The Financial Aid Office will compare the
information reported on the FAFSA for you and your parent(s) with the information reported on this worksheet and any other required
documentation. *Your eligibility for financial aid cannot be determined until the verification process has been completed.
STUDENT NAME:
____________________________________________________________ WCC ID #: ______________________________
ADDRESS: _________________________________________________________________________________________________________________
STREET OR PO BOX CITY STATE ZIP
E-MAIL ADDRESS: ___________________________________________________________ PHONE #: _______________________________
INSTRUCTIONS: You, and a parent whose information was reported on the FAFSA, must complete this worksheet, attach any
required documentation, sign, and submit the completed package to the WCC Financial Aid Office.
If your parent was married (or remarried) on the day you signed and submitted your FAFSA, you are required to provide information for
each parent and/or step-parent. If there are any discrepancies between the information reported on the FAFSA and the documents
submitted to our office, your signature on this form authorizes our office to make the appropriate corrections to your FAFSA.
Additional information may be needed to complete your file. If you have any questions about the verification process, contact the
Financial Aid Office as soon as possible to avoid a delay in processing your request for financial aid.
A. PARENTS’ HOUSEHOLD SIZE
NOTE: The following guidelines apply to DEPENDENT students only. (Independent students should complete the IV1/IV5 form)
1. IN THE SPACES BELOW, PRINT THE NAMES OF ALL MEMBERS OF YOUR PARENTS’ HOUSEHOLD INCLUDING:
Yourself; even if you do not live with your parent(s);
Your parent(s) and/or step-parent;
Your parents other children, even if they do not live with your parent(s), IF your parent(s) will provide more than half of
their support between July 1, 2018 and June 30, 2019, OR if the children would be considered dependent when completing
a 2018-2019 FAFSA;
Other people ONLY if they now live with your parent(s) AND your parent(s) provide more than half of their support AND
will continue to provide more than half of their support between July 1, 2018 and June 30, 2019.
NOTE: Support includes money, gifts, loans, housing, food, clothing, transportation, medical/dental care, college
tuition, etc. **Supplementary documentation may be required to prove support of dependents other than your parent’s
children.
2. COLLEGE STUDENTS - If any household member listed below will be a college student during the 2018-2019 school year,
enter the name of the college they will be attending. Always count yourself as a college student. DO NOT INCLUDE your
parents, nor siblings who are enrolled in U.S. military service academies. Include others only if they will enroll, at least half-time,
in a program that leads to a college certificate, diploma or degree.
HOUSEHOLD MEMBER NAME AGE
RELATIONSHIP TO
STUDENT
COLLEGE ATTENDING
2018-2019
Self
Wayne Community College
~If more space is needed, attach a separate page that includes the student’s name and WCC ID#~
RETURN THIS COMPLETED FORM WITH REQUIRED DOCUMENTATION TO:
Wayne Community College - Financial Aid Office - PO Box 8002 - Goldsboro, NC 27533-8002
FAX: 919-736-9425
Wayne Community College is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award associate degrees.
Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097 or call 404-679-4500 for questions about the accreditation
of Wayne Community College. The Commission on Colleges may be contacted only if there is evidence that Wayne Community College is significantly
non-compliant with a requirement or standard. Accreditation standards are located at http://www.sacscoc.org/principles.asp.
Inquiries about Wayne Community College, such as admission requirements, financial aid, educational programs, etc. should be addressed directly to
Wayne Community College and not the Commission’s office.
IMPORTANT: If your parent(s) were married OR remarried on the day you signed and submitted the FAFSA, you must answer
all tax and income questions for both parents and/or step-parent.
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 2016 income information that was transferred into the
student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.
B. TAX FILING STATUS
STUDENT (check ONE only)
PARENT(S) (check ONE only)
Check here if you filed a 2016 federal tax return AND
used/will use the IRS DATA RETRIEVAL TOOL to transfer
tax information into the FAFSA. {Skip to section D}
Check here if your parent(s) filed a 2016 federal tax return
AND used/will use the IRS DATA RETRIEVAL TOOL to
transfer tax information into the FAFSA. {Skip to section D}
Check here if you filed a 2016 federal tax return but did not
and will not use the IRS Data Retrieval Tool. You are
required to provide a signed copy of your 2016 IRS TAX
RETURN TRANSCRIPT*. {Skip to section D}
Check here if your parent(s) filed a 2016 federal tax return
but did not and will not use the IRS Data Retrieval Tool.
You are required to provide a signed copy of your
parents’ 2016 IRS TAX RETURN TRANSCRIPT* {Skip to
section D}
Check here if you will not file a 2016 federal tax return. You
are required to complete the NON-TAX FILERS
STATEMENT in section C.
Check here if your parent(s) will not file a 2016 federal tax
return. Your parent(s) is required to complete the NON-
TAX FILERS STATEMENT in section C.
*REQUEST IRS TAX RETURN TRANSCRIPTS @ WWW.IRS.GOV
C. NON-TAX FILERS STATEMENT
(complete this section ONLY if you OR your parent(s) did not file a 2016 IRS tax return)
IMPORTANT: The Department of Education requires certain non-tax filers to submit a VERIFICATION OF NON-FILIING letter
(available via www.irs.gov). The letter must be dated on or after October 1, 2017, and be signed by the individual named in the letter.
**Remember to include the student name and WCC ID # on all documents submitted.
STUDENT (check ONE only)
PARENT(S) (check ONE only)
I was UNEMPLOYED for all of 2016.
I/We was/were UNEMPLOYED for all of 2016
I earned income from working in 2016 but I DID NOT, WILL
NOT, and am NOT REQUIRED to file a federal tax return.
ALL employers and earned income amounts are listed
below. I am attaching copies of ALL 2016 W-2’s, 1099’s,
and/or other statements of income provided by my
employer(s).
I/We earned income from working in 2016 but I/WE DID
NOT, WILL NOT, and am NOT REQUIRED to file a federal
tax return. ALL employers and earned income amounts are
listed below. I am attaching copies of ALL 2016 W-2’s,
1099’s, and/or other statements of income provided by
my/our employer(s).
NAME OF EMPLOYER
STUDENT 2016
EARNINGS
W-2 or 1099
PROVIDED?
PARENT 2016
W-2 or 1099
PROVIDED?
Example: XYZ Department Store 0 N/A $7000 Yes
~If more space is needed, attach a separate page that includes the student’s name and WCC ID#~
D. CERTIFICATION AND SIGNATURES
By signing below
, I certify that all information reported on this form and any documentation provided is true and complete.
__________________________________________________ _______________________
STUDENT SIGNATURE (REQUIRED)
DATE
__________________________________________________ _______________________
PARENT SIGNATURE (REQUIRED)
DATE
WARNING: If you purposely provide false or misleading information to obtain financial aid, you may be fined, sentenced to jail, or both.
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