1 CONTINUED ON REVERSE
2018-2019
Independent Verification Worksheet (IV1/IV5)
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 spouse (if married) 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: Complete this worksheet, attach any required documentation, sign, and submit the completed package to
the WCC Financial Aid Office.
If you were married on the day you signed and submitted your FAFSA, you are required to include information for your spouse. 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. STUDENT’S HOUSEHOLD SIZE
NOTE: The following guidelines apply to INDEPENDENT students only. (Dependent students should complete the DV1/DV5 form)
1. IN THE SPACES BELOW, PRINT THE NAMES OF ALL MEMBERS OF YOUR HOUSEHOLD INCLUDING:
Yourself;
Your spouse (if you were married on the day you signed and submitted your FAFSA);
Your and/or your spouse’s children IF you and/or your spouse will provide more than half of their support between
July 1, 2018 and June 30, 2019, even if the children do not live with you;
Other people ONLY if they now live with you AND you and/or your spouse 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 spouse
and children.
2. COLLEGE STUDENTS - If any household member listed below will be a college student during 2018-2019, enter the name of
the college they will be attending. Always count yourself as a college student. 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 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 you were married on the day you signed and submitted the FAFSA, you must answer all tax and income
questions for you AND your spouse. **If you were not married or were separated, please ignore all references to “spouse”.
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)
SPOUSE (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 spouse 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 spouse 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 spouse’s
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 below.
Check here if your spouse will not file a 2016 federal tax
return. Your spouse is required to complete the NON-TAX
FILERS STATEMENT in section C below and sign this
form in section D.
*REQUEST IRS TAX RETURN TRANSCRIPTS @ WWW.IRS.GOV
C. NON-TAX FILERS STATEMENT
(complete this section ONLY if you OR your spouse did not file a 2016 IRS tax return)
IMPORTANT: The Department of Education requires certain non-tax filers to submit a VERIFICATION OF NON-FILING 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)
SPOUSE (check ONE only)
I was
UNEMPLOYED
for all of 2016. I was
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 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).
NAME OF EMPLOYER
STUDENT 2016
EARNINGS
W-2 or 1099
PROVIDED?
SPOUSE 2016
EARNINGS
W-2 OR 1099
PROVIDED?
$1400
Yes
N/A
N/A
~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.
_____________________
DATE
________________________
__________________________________________________
STUDENT SIGNATURE (REQUIRED)
________________________________________________________
SPOUSE SIGNATURE (REQUIRED FOR NON-TAX FILERS)
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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