2019-20
CA Dream Act Application
Dependent Verification Worksheet
Feather River College Financial Aid Office 570 Golden Eagle Avenue, Quincy CA 95971
Phone (530) 283-0202 ext 603 Fax (530) 283-4659 Email: financialaid@frc.edu
www.frc.edu/financialaid
DV1W20
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Your California Dream Act Application (CADAA) has been selected for a process called verification. Please complete all parts of this worksheet and
return to the Financial Aid Office. Notice: incomplete forms may delay processing.
B. Household Information List the members in your parents’ household. Attach an additional sheet if necessary.
Please include: yourself, even if you don’t live with your parents, your parents/step-parent (if your parent is remarried you must include your step-
parent), your parents’ other children (even if they do not live with your parents), siblings, and individuals who will receive more than half of their
support from your parents between July 1, 2019 and June 30, 2020.
Full Name
Relationship to
Student
Age
Enrolled in College
at least half-time
(check one)
College
Self
No
Feather River College
No
No
No
No
No
C. Tell us about your 2017 tax filing status
Student’s Filing Status (select only one)
I filed my 2017 return. Submit your 2017 IRS Tax Return
Transcript.
I amended my taxes after originally filing my 2017 return
and will submit:
o 2017 IRS Tax Return Transcript
o 2017 Signed IRS 1040X form
I did not and I am not required to file a federal tax return. I
was not employed and earned no income from work in 2017.
Submit 2017 IRS Verification of Non-filing Letter*
I did not and I am not required to file a federal tax return. In
2017, I earned $__________ from the source(s) listed below:
Submit 2017 IRS Verification of Non-filing Letter*
Employer’s Name
2017 Earned
Amount
IRS W-2 Attached
Yes
No
Yes
No
Yes
No
Attach all W-2s issued to you in 2017
*IRS Verification of Non-Filing Letters can be requested by checking box 7 and
8 (if no W-2s provided) on IRS Form 4506-T. Notice: 2017 IRS Verification of
Non-Filing Letters must be dated on or after October 1, 2018.
Parent(s) Filing Status (select only one)
My parent(s) filed their 2017 tax return. Submit parent’s
2017 IRS Tax Return Transcript.
My parent(s) amended their taxes after originally filing
their return and will submit:
o 2017 IRS Tax Return Transcript
o 2017 Signed IRS 1040X form
My parent(s) did not and is/are not required to file a federal
tax return. My parent(s) were not employed and earned no
income from work in 2017. Submit 2017 IRS Verification of
Non-filing Letter*
My parent(s) did not and is/are not required to file a federal
tax return. In 2017, my parent(s) earned $___________
from the source(s) listed below: Submit 2017 IRS Verification of
Non-filing Letter*
Employer’s Name
2017 Earned
Amount
IRS W-2 Attached
Yes
No
Yes
No
Yes
No
Attach all W-2s issued to your parent(s) in 2017
*IRS Verification of Non-Filing Letters can be requested by checking box 7 and
8 (if no W-2s provided) on IRS Form 4506-T. Notice: 2017 IRS Verification of
Non-Filing Letters must be dated on or after October 1, 2018.
D. Certification and Signatures Each person signing this worksheet certifies that all of the information reported on it is complete
and correct. The student and one parent whose information was reported on the California Dream Act Application (CADAA) must
sign and date. Warning! If you purposely give false or misleading information you may be fined, sentenced to jail, or both.
Student Signature: _____________________________________________________ Date: ___________________
Parent Signature: ______________________________________________________ Date: ___________________
This worksheet must be signed and dated to be valid. Electronic and/or digital signatures are not valid.
A. Student Information
Student’s Name: ________________________________________________ FRC ID: ________________________
Clear Form
IRS Data Retrieval Tool
and Tax Return Transcripts Instructions
How to request your 2017 Tax Return Transcripts from the IRS
From the IRS website, you can request a tax return transcript through their Get Transcript Online or Get Transcript by Mail options. You can also
contact the IRS by phone to request your tax return transcript. Note: the method you used to file your return and whether you have a refund or balance
due, affects your current year transcript availability.
Get Transcript Online
Get Transcript by Mail
Get Transcript by Phone
To use this service you need:
Full Name;
Email;
Date of birth;
Your Social Security Number or Individual Tax
Identification Number (ITIN);
Tax Filing Status;
Current address;
Personal account number from a credit card,
mortgage, home equity loan, home equity line of
credit or car loan and,
Mobile phone with your name on the account.
Note: if account setup is successful you will be able
to download and/or print your tax return transcript.
To use this service you need:
Your Social Security Number or Individual
Tax Identification Number (ITIN);
Date of birth and,
Mailing address from your latest tax return
Note: transcripts generally arrive in 5-10
calendar days to the address the IRS has on file
for you. The IRS will never send an email
requesting that you obtain or access your
transcripts. If you receive such a notice, please
forward to the IRS fraud group at
phishing@irs.gov.
Call (800) 908-9946 and follow the
telephone prompts.
Notice: Be sure to request an IRS Tax Return Transcript not an IRS Tax Account Transcript.
How to request an IRS Verification of Non-Filing Letter for 2017
Go to the IRS website at https://www.irs.gov/ and click on Search Forms & Instructions. On this page click to select Form 4506-T and
follow the instructions on the form. IRS Verification of Non-Filing Letters can be requested by checking box 7 and 8 (if no W-2s
provided) on IRS Form 4506-T. Notice: 2017 IRS Verification of Non-Filing Letters must be dated on or after October 1, 2018.