Fillable 2018-2019 Low/No Income Verification Worksheet - Independent Students (Wayne Community College)

Fill Online, Printable, Fillable, Blank 2018-2019 Low/No Income Verification Worksheet - Independent Students (Wayne Community College) Form

Use Fill to complete blank online WAYNE COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

2018-2019 Low/No Income Verification Worksheet - Independent Students (Wayne Community College)

On average this form takes 16 minutes to complete

The 2018-2019 Low/No Income Verification Worksheet - Independent Students (Wayne Community College) form is 2 pages long and contains:

  • 0 signatures
  • 42 check-boxes
  • 45 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Wayne Community College

BROWSE WAYNE COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1 CONTINUED ON REVERSE
2018-2019
Low/No Income Verification Worksheet - Independent Students
The income reported on your 2018-2019 FAFSA appears to be too low to meet basic living expenses. While this may be due to the
exclusion of certain types of income from the FAFSA, 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.
This worksheet may be requested in addition to other verification forms required by the U.S. Department of Education. *Your eligibility
for financial aid cannot be determined until the verification process has been completed.
WCC ID #:
_______________________________
STUDENT NAME: ___________________________________________________________
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 your FAFSA and the documents
submitted to our office, your signature on this form authorizes our office to make the appropriate corrections to your FAFSA.
**For FAFSA purposes, your household includes you, your spouse (if you were married on the day you signed and submitted the
FAFSA), and your or your spouse’s children IF you 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 and your spouse. Include other people ONLY if they now live with you AND you
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. IMPORTANT: These guidelines apply to INDEPENDENT students only. (Dependent students should complete the
Low/No Income Verification Worksheet-Dependent Students)
NOTE: Support includes money, gifts, loans, housing, food, clothing, transportation, medical/dental care, college tuition, etc.
A. TAXABLE INCOME (enter a response for EACH question below; incomplete forms will be returned)
Did any member of your household receive income
from the sources listed below during 2016?
TOTAL RCVD
IN 2016
IF YES, SUBMIT REQUIRED
DOCUMENTATION
Money earned from working (including cash
earnings that were not reported on a W2 or 1099)
+
YES
NO
$ ______________
All 2016 W-2’s, 1099’s, and/or other
statements of income earned
Unemployment Compensation YES NO $ ______________ 2016 Form 1099-G
Pension or Retirement Funds
YES
NO
$ ______________
2016 Form 1099-R
Business, Rental or Farm Income
YES
NO
$ ______________
2016 Form 1099-MISC, 1099-G, etc.
Disability Payments
YES
NO
$ ______________
2016 SSA-1099, Form 1099-R or W-2
Alimony or Spousal Support
YES
NO
$ ______________
Copy of the Court Order
Gambling or Lottery Winnings
YES
NO
$ ______________
2016 Form W-2G
Interest or Dividends
YES
NO
$ ______________
2016 Form 1099-INT or 1099-DIV
ENTER THE TOTAL OF ALL SOURCES OF TAXABLE INCOME HERE
$ ______________
+
Per IRS guidelines, individuals earning net self-employment income of $400 or more are required to file a tax return.
B. UNTAXED INCOME (enter a response for EACH question below; incomplete forms will be returned)
Did any member of your household receive income
TOTAL RCVD
IN 2016
IF YES, SUBMIT REQUIRED
DOCUMENTATION
Supplemental Security Income (SSI)
YES
NO
$ _____________
2016 Benefit Verification Letter
Child Support for any of your OR your spouse’s
children
YES NO
$ _____________
Proof of Child Support received
January – December 2016
Worker’s Compensation
YES
NO
$ _____________
Final Check Stub from 2016
Veteran’s Non-Educational Benefits
YES
NO
$ _____________
VA Award Letter
$ ___________
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.
C. INCARCERATION (check the appropriate box; incomplete forms will be returned)
Were you or your spouse confined to jail/prison at any time
during 2016?
YES NO
If YES, submit proof of the incarceration period
(documentation may vary depending on location)
D. PUBLIC ASSISTANCE (enter a response for EACH question below; incomplete forms will be returned)
Did any member of your household receive benefits from
the sources listed below during 2016 or 2017?
MONTHLY
VALUE
HOW MANY MONTHS
RCVD IN 2016?
Housing Assistance (Section 8, HUD, etc.)
YES
NO
$________________
_____________
Work First/TANF YES NO
$________________ _____________
Food & Nutrition Services (Food Stamps, SNAP, etc.) YES NO
$________________ _____________
Medicaid or WIC (circle one OR both) YES NO
$________________ _____________
ENTER THE TOTAL MONTHLY VALUE OF ALL BENEFITS HERE
$________________
E. ADDITIONAL INFORMATION (answer EACH question below; forms with blank responses will be returned)
Did any member of your household receive income OR support from the sources listed below in 2016 OR 2017?
Refunds from Federal and/or State Financial Aid YES NO
Cash support provided by a parent, relative or friend
(to cover transportation, miscellaneous personal items, etc.)
YES NO
Payment of bills listed in your name by a parent, relative,
friend, or relief agency
(Salvation Army, church, etc.)
YES NO
Housing provided at no cost to you by a parent, relative,
friend, or relief agency
(Salvation Army, church, etc.)
YES NO
Food and/or groceries provided at no cost to you by a
parent, relative, friend, or relief agency
(Salvation Army,
church, etc.)
YES NO
If YES, what school did the household
member attend?
_______________________
If YES, who provided the cash support?
Name: ___________________________
Relationship to you:_________________
TOTAL amount received in 2016: $_______
If YES, who paid the bills?
Name: ___________________________
Relationship to you: ________________
TOTAL amount paid in 2016: $__________
If YES, who provided the housing?
Name: ___________________________
Relationship to you: ________________
# of months housing was provided: ______
If YES, who provided the food/groceries?
Name: ___________________________
Relationship to you: ________________
# of months received: ______________
USE THE SPACE BELOW TO PROVIDE ANY OTHER INFORMATION NEEDED TO EXPLAIN HOW BASIC LIVING EXPENSES
(food, shelter, utilities, clothing, personal items, etc.) WERE MET IN 2016.
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
~If more space is needed, attach a separate page that includes the student’s name and WCC ID#.
F. 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
________________________________________________________ _______________________
SPOUSE SIGNATURE (OPTIONAL)
DATE
WARNING: If you purposely provide false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
VOUCHER ONLY
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

2018-2019 LowNo Income Verification Worksheet - Independent Students (Wayne Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document