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.
2018-2019
Verification of Marital Status – Independent Students (MSI)
Our office needs to verify the marital status reported on your 2018-2019 FAFSA. *Your eligibility for financial aid cannot be
determined until the verification process has been completed.
STUDENT NAME:
____________________________________________________________ WCC ID #: ______________________________
E-MAIL ADDRESS: ___________________________________________________________ PHONE #: _______________________________
INSTRUCTIONS: Complete this form, attach any required documentation, sign, and submit the completed package to the WCC
Financial Aid Office for review.
A. STUDENT’S MARITAL STATUS
On the day I signed the 2018-2019 FAFSA, my marital status was: REQUIRED DOCUMENTATION
Single
Not Applicable
Married/Remarried
Date of Marriage:
_______/__________
MM YYYY
A copy of your marriage license
Widowed
Date you were Widowed:
_______/__________
MM YYYY
A copy of the death certificate or obituary notice
Check here if you submitted the documents in
a prior year and specify the year: __________
Divorced
Date of Divorce:
_______/__________
MM YYYY
A copy of your final divorce decree
Check here if you submitted the documents in
a prior year and specify the year: __________
Separated
Date of Separation:
_______/__________
MM YYYY
A copy of your LEGAL separation papers OR
complete the Declaration of Separation below.
B. DECLARATION OF SEPARATION (complete this section ONLY if you are separated and do not have legal separation papers)
I have been separated from my spouse, __________________________________________, since _______/__________. We DO NOT have
PRINT NAME OF SPOUSE MM YYYY
legal separation papers but have been living apart continuously with no plans to reconcile since the month and year indicated above.
I am attaching TWO (2) types of supporting documentation listed below to support this statement.
An official letter from a reputable third party who can confirm
my marital separation in his/her professional capacity
(ex. employer, religious/spiritual leader; marriage counselor;
landlord; etc.).
A copy of my lease, rental, or mortgage documents.
Most recent two (2) months utility bills for EACH spouse
confirming separate households.
Legal documents showing child support obligations.
For members of the military or their dependents: a letter
from the Family Services Office, Unit Chaplain, or Unit S-1
Personnel Office confirming their knowledge of my marital
An official letter from a social services agency (ex. DSS,
Social Security, etc.) indicating their knowledge of my
marital separation AND confirming that I am considered
separated for the purposes of their program OR that lists all
household members by name.
A copy of my SIGNED 2017 IRS TAX RETURN
TRANSCRIPT (available @ www.irs.gov
). NOTE: If you
separated before December 31, 2017, and filed a joint return
with your estranged spouse, you must include an official
letter from a tax expert that explains why you filed jointly.
OTHER: Please Specify: ___________________________
C. CERTIFICATION AND SIGNATURE
By signing below, I certify that all information reported on this form and any documentation provided is true and complete.
__________________________________________________ _______________________
STUDENT SIGNATURE (REQUIRED) DATE
WARNING: If you purposely provide false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
