Fillable 2019-20 Verification Dependent Student Form (Eastern Florida State College)

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2019-20 Verification Dependent Student Form (Eastern Florida State College)

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The 2019-20 Verification Dependent Student Form (Eastern Florida State College) form is 9 pages long and contains:

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  • 43 check-boxes
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* This form must be submitted by the priority deadline to ensure a determination of eligibility before the Fee Due Date. Students may still apply
for aid after the priority deadlines, but EFSC cannot guarantee that late submissions will be notified of aid eligibility prior to the Fee Due Date.
1
04/06/20
20V5D
FA Verification
2019-20 Verification Dependent Student Form
V5 – Aggregate Verification Group
Your 2019–2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification.
About 30% of all FAFSA filers are selected for verification, which requires the school to collect documentation to review
the accuracy of FAFSA information. EFSC cannot award federal financial aid until this worksheet has been processed.
Priority Deadlines*: Fall 2019 – 07/18/19 | Spring 2020 – 11/25/19 | Summer 2020 – 04/23/20
A. Student Information
B#
Last Name First Name M.I. Student ID
B. Household Information
List below the people in your parent’s household. Include only the following:
• Yourself.
• Your parent(s) (including a stepparent) even if you do not live with your parent(s).
• Your parent’s other children if your parent(s) will provide more than half of the children’s support from July
1, 2019, through June 30, 2020 or if the other children would be required to provide parental information if
they were completing a FAFSA for 2019-20. Include children who meet either of these standards, even if the
child does not live with your parents.
• Other people if they now live with your parent(s) and your parent(s) provide more than half of the other
person’s support and will continue to provide more than half of that person’s support through June 30,
2020.
Full Name
Age
Relationship
College
(List only if household member will
attend at least ½ time; Do not include
dual-enrolled high school students )
Will be
Enrolled at
Least ½ Time?
(Yes or No)
Self
Eastern Florida State College
If more space is needed, submit a separate page with your name and B number. EFSC may require additional
documentation if we have reason to believe the information regarding the household members is incomplete or
inaccurate.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
2
04/06/20
C. Student Income Information – You must check only 1 box below.
☐ I filed a 2017 IRS tax return. – Go to Section #1 below.
☐ I did not and will not file a 2017 IRS tax return. – Go to Section #2 on page 3.
☐ I was granted a tax extension, filed an amended return, was a victim of IRS tax-related identify theft, or filed a
non-IRS income tax return for 2017. – Go to Section #3 on page 4.
1. STUDENT TAX RETURN FILERS (IRS FORM 1040, 1040A or 1040EZ)
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. Use of the IRS DRT is strongly recommended.
Check the box that applies:
☐ I have used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2017 IRS income tax return
information into my FAFSA.
☐ I have not yet used the IRS Data Retrieval Tool in the FAFSA, but will use the tool to transfer 2017 IRS
income tax return information into my FAFSA. Verification cannot be completed until the IRS
information has been transferred into the FAFSA.
☐ I am unable or choose not to use the IRS Data Retrieval Tool in the FAFSA. I will submit to EFSC a 2017
IRS tax return transcript or a signed copy of the 2017 IRS Form 1040, 1040A or 1040EZ I filed with the
IRS. You must check one box below.
☐ My 2017 IRS tax return transcript is attached to this worksheet.
☐ My 2017 IRS tax return transcript will be submitted to EFSC later. Verification cannot be
completed until the IRS tax return transcript has been submitted to EFSC.
☐ My signed copy of the 2017 IRS Form 1040, 1040A or 1040EZ I filed with the IRS is attached to
this worksheet.
☐ My signed copy of the 2017 IRS tax form 1040, 1040A or 1040EZ I filed with the IRS will be
submitted to EFSC later. Eligibility for aid cannot be determined until one of the IRS tax
documents is received.
Note: Although the 1040 you have may include additional schedules and/or worksheets, EFSC needs only
the signed IRS Form 1040/1040A/1040EZ which typically consists of 2 pages.
A 2017 IRS Tax Return Transcript may be obtained through:
Get Transcript ONLINE
• Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript Online.”
• To use the new Get Transcript Online tool, the user must have (1) access to a valid email address,
(2) a text-enabled mobile phone (pay-as-you-go plans cannot be used) in the user’s name, and (3)
specific financial account numbers (such as a credit card number or an account number for a
home mortgage or auto loan). The transcript displays online upon successful completion of the
IRS’s two-step authentication.
• Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Get Transcript by MAIL
• Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript by Mail.”
• Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Paper Request Form
• Complete IRS Form 4506-EZ and mail or fax to the IRS.
• Do NOT request to have your transcript mailed directly to EFSC.
• Please allow a minimum of 5-10 days to receive the transcript.
Go to Section D on page 5.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
3
04/06/20
2. STUDENT TAX RETURN NONFILERS
Complete this section if you will not file and are not required to file a 2017 income tax return with the IRS.
Check the box that applies:
☐ I was not employed and had no income earned from work in 2017.
☐ I was employed in 2017 and have listed below the names of all employers, the amount earned from
each employer in 2017, and whether an IRS W-2 form is attached. You are required to submit a copy of
each W-2 that was issued. List every employer even if they did not issue an IRS W-2 form.
IRS W-2 Issued
by Employer
IRS W-2
Attached
2017 Amount Earned
Yes(example)
Yes(example)
$2,000.00(example)
Total Amount of Income Earned From Work
$
Go to Section D on page 5.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
4
04/06/20
3. STUDENT TAX FILERS WITH UNUSUAL CIRCUMSTANCES
If you are a tax filer with unusual circumstances for 2017, indicate below and submit all required documents
listed. Verification cannot be completed until all documents are submitted. Check the box that applies:
☐ I was granted a filing extension by the IRS.
If you are required to file a 2017 IRS income tax return and have been granted a filing extension by the
IRS you must provide:
• A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income
Tax Return,’’ that was filed with the IRS for tax year 2017; AND
• A copy of the IRS's approval of an extension beyond the automatic six-month extension; AND
• Verification of Non-filing Letter (confirmation that the tax return has not yet been filed) from the IRS
or other relevant tax authority dated on or after October 1, 2018; AND
• A copy of IRS Form W–2 for each source of employment income received for tax year 2017 and, if
self-employed, a signed statement certifying the amount of your Adjusted Gross Income (AGI) and
the U.S. income tax paid for tax year 2017.
☐ I filed an amended IRS income tax return (1040X).
If you filed an amended IRS income tax return for tax year 2017 you must provide:
• A 2017 IRS Tax Return Transcript (that will only include information from the original tax return and
does not have to be signed), or any other IRS tax transcript(s) that includes all of the income and tax
information required to be verified AND
• A signed copy of the 2017 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was
filed with the IRS.
☐ I am a victim of IRS tax-related identity theft.
If you were a victim of IRS tax-related identity theft you must provide:
• A Tax Return DataBase View (TRDBV) transcript obtained from the IRS by calling the Identify
Protection Specialized Unit (IPSU) at 1-800-908-4490, or any other IRS tax transcript(s) that includes
all of the income and tax information required to be verified AND
• A statement signed and dated by you indicating that you were a victim of IRS tax-related identity
theft and that the IRS is aware of the tax-related identity theft.
☐ I filed a non-IRS income tax return.
• A tax filer who filed an income tax return with Guam, the Commonwealth of the Northern Mariana
Islands, the Commonwealth of Puerto Rico and the U.S. Virgin Islands may provide a signed copy of
his or her income tax return that was filed with the relevant tax authority. However, if we question
the accuracy of the information on the signed copy of the income tax return, the tax filer must
provide us with a copy of the tax account information issued by the relevant tax authority before
verification can be completed.
• A tax filer who filed an income tax return with the tax authority for American Samoa must provide a
copy of his or her tax account information.
• A tax filer who filed an income tax return with tax authorities not mentioned above, i.e. a foreign tax
authority, and who indicates that he or she is unable to obtain the tax account information free of
charge, must provide documentation that the tax authority charges a fee to obtain that information,
along with a signed copy of his or her income tax return that was filed with the relevant tax
authority.
Go to Section D on page 5.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
5
04/06/20
D. Parent Income Information – You must check only 1 box below.
NOTE: The instructions below apply to each parent included in the household in Section B of this worksheet.
Notify the Office of Financial Aid if your parents had a change in marital status after December 31, 2017.
☐ My parent(s) filed a 2017 IRS tax return. – Go to Section #1 below.
☐ My parents(s) did not and will not file a 2017 IRS tax return. – Go to Section #2 on page 6.
☐ My parents(s) was/were granted a tax extension, filed an amended return, was a victim of IRS tax-related
identify theft, or filed a non-IRS income tax return for 2017. – Go to Section #3 on page 7.
1. PARENT IRS TAX RETURN FILERS (IRS FORM 1040, 1040A or 1040EZ)
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. Use of the IRS DRT is strongly recommended.
Check the box that applies:
☐ My parent(s) already used the IRS Data Retrieval Tool (DRT) in FAFSA on the Web to transfer 2017 IRS
income tax return information into my FAFSA
☐ My parent(s) have not yet used the IRS Data Retrieval Tool in the FAFSA, but will use the tool to transfer
2017 IRS income tax return information into my FAFSA. Verification cannot be completed until the IRS
information has been transferred into the FAFSA.
☐ My parent(s) are unable or choose not to use the IRS Data Retrieval Tool in the FAFSA. I will submit to
EFSC a 2017 IRS tax return transcript or a signed copy of the 2017 IRS Form 1040, 1040A or 1040EZ my
parent(s) filed with IRS. You must check one box below.
☐ My parents’ 2017 IRS tax return transcript is attached to this worksheet.
☐ My parents’ 2017 IRS tax return transcript will be submitted to EFSC later. Verification cannot be
completed until the IRS tax return transcript has been submitted to EFSC.
☐ My parent’s signed copy of the 2017 IRS Form 1040, 1040A or 1040EZ filed with the IRS is
attached to this worksheet.
☐ My parent’s signed copy of the 2017 IRS tax form 1040, 1040A or 1040EZ filed with the will be
submitted to EFSC later. Eligibility for aid cannot be determined until one of the IRS tax
documents is received.
Note: Although the 1040 you have may include additional schedules and/or worksheets, EFSC needs only
the signed IRS Form 1040/1040A/1040EZ which typically consists of 2 pages.
A 2017 IRS Tax Return Transcript may be obtained through:
Get Transcript ONLINE
• Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript Online.”
• To use the new Get Transcript Online tool, the user must have (1) access to a valid email address,
(2) a text-enabled mobile phone (pay-as-you-go plans cannot be used) in the user’s name, and (3)
specific financial account numbers (such as a credit card number or an account number for a
home mortgage or auto loan). The transcript displays online upon successful completion of the
IRS’s two-step authentication.
• Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Get Transcript by MAIL
• Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript by Mail.”
• Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Paper Request Form
• Complete IRS Form 4506-EZ and mail or fax to the IRS.
• Do NOT request to have your transcript mailed directly to EFSC.
• Please allow a minimum of 5-10 days to receive the transcript.
• Do NOT request to have your transcript mailed directly to EFSC.
• Please allow a minimum of 5-10 days to receive the transcript.
Go to Section E on page 8.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
6
04/06/20
2. PARENT TAX RETURN NONFILERS
Complete this section if your parent(s) will not file and is/are not required to file a 2017 income tax return
with the IRS.
Check the box that applies:
☐ Neither parent was employed and neither had income earned from work in 2017.
☐ One or both parents was/were employed in 2017 and have listed below the names of all their
employers, the amount earned from each employer in 2017, and whether an IRS W-2 form is attached.
You are required to submit a copy of each W-2 that was issued. List every employer even if they did not
issue an IRS W-2 form.
IRS W-2 Issued
by Employer
IRS W-2
Attached
2017 Amount Earned
Yes(example)
Yes(example)
$2,000.00(example)
Total Amount of Income Earned From Work
$
Your parents(s) MUST submit an IRS Verification of Non-filing Letter. This is a new federal
requirement for 2019-20 and applies even if your parents earned zero income in 2017.
☐ My parents’ 2017 IRS Verification of Non-filing Letter(s) is/are attached to this worksheet.
☐ My parents’ 2017 IRS Verification of Non-filing Letter(s) will be submitted to EFSC later.
Verification cannot be completed until the IRS tax return transcript has been submitted to EFSC.
A 2017 IRS Verification of Non-filing Letter may be obtained through the following methods.
NOTE: if your parents have NEVER filed a tax return, they MUST use the Paper Request Form.
Get Transcript ONLINE
• Go to www.irs.gov, click under the Tools heading, click "Get Your Tax Record.”
• Click “Get Transcript Online.”
• Make sure to request the “Verification of Non-Filing Letter.”
Get Transcript by MAIL
• Go to www.irs.gov, click under the Tools heading, click "Get Your Tax Record.”
• Click “Get Transcript by Mail.”
• Make sure to request the “Verification of Non-Filing Letter.”
Paper Request Form
• Complete IRS Form 4506-T and mail or fax to the IRS
• Do NOT request to have your Verification of Non-Filing mailed directly to EFSC.
• Please allow a minimum of 5-10 days to receive the Verification of Non-Filing.
Go to Section E on page 8.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
7
04/06/20
3. PARENT TAX FILERS WITH UNUSUAL CIRCUMSTANCES
If your parent(s) is/are a tax filer(s) with unusual circumstances for 2017, indicate below and submit all
required documents listed. Verification will not be completed until all required documents listed below are
submitted.
Check the box that applies:
☐ I was granted a filing extension by the IRS.
If you are required to file a 2017 IRS income tax return and have been granted a filing extension by the
IRS you must provide:
• A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income
Tax Return,’’ that was filed with the IRS for tax year 2017; AND
• A copy of the IRS's approval of an extension beyond the automatic six-month extension; AND
• Verification of Non-filing Letter (confirmation that the tax return has not yet been filed) from the IRS
or other relevant tax authority dated on or after October 1, 2018; AND
• A copy of IRS Form W–2 for each source of employment income received for tax year 2017 and, if
self-employed, a signed statement certifying the amount of your Adjusted Gross Income (AGI) and
the U.S. income tax paid for tax year 2017.
☐ I filed an amended IRS income tax return (1040X).
If you filed an amended IRS income tax return for tax year 2017 you must provide:
• A 2017 IRS Tax Return Transcript (that will only include information from the original tax return and
does not have to be signed), or any other IRS tax transcript(s) that includes all of the income and tax
information required to be verified AND
• A signed copy of the 2017 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was
filed with the IRS.
☐ I am a victim of IRS tax-related identity theft.
If you were a victim of IRS tax-related identity theft you must provide:
• A Tax Return DataBase View (TRDBV) transcript obtained from the IRS by calling the Identify
Protection Specialized Unit (IPSU) at 1-800-908-4490, or any other IRS tax transcript(s) that includes
all of the income and tax information required to be verified AND
• A statement signed and dated by you indicating that you were a victim of IRS tax-related identity
theft and that the IRS is aware of the tax-related identity theft.
☐ I filed a non-IRS income tax return.
• A tax filer who filed an income tax return with Guam, the Commonwealth of the Northern Mariana
Islands, the Commonwealth of Puerto Rico and the U.S. Virgin Islands may provide a signed copy of
his or her income tax return that was filed with the relevant tax authority. However, if we question
the accuracy of the information on the signed copy of the income tax return, the tax filer must
provide us with a copy of the tax account information issued by the relevant tax authority before
verification can be completed.
• A tax filer who filed an income tax return with the tax authority for American Samoa must provide a
copy of his or her tax account information.
• A tax filer who filed an income tax return with tax authorities not mentioned above, i.e. a foreign tax
authority, and who indicates that he or she is unable to obtain the tax account information free of
charge, must provide documentation that the tax authority charges a fee to obtain that information,
along with a signed copy of his or her income tax return that was filed with the relevant tax
authority.
Go to Section E on page 8.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
8
04/06/20
E. High School Completion Status
Please indicate your high school completion status when you begin college in 2019–2020:
☐ I received or will have received a high school diploma.
☐ I completed or will have completed secondary education in a foreign country and have a copy of the
“secondary school leaving certificate” or other similar document.
☐ I have or will have passed a state authorized examination (GED test, HiSET, TASC, or other State-authorized
examination).
☐ I completed or will have completed at least a two-year program that is acceptable for full credit towards a
bachelor’s degree.
☐ I was homeschooled.
F. Identity and Statement of Educational Purpose
You must verify your identity by mailing or uploading a copy of a valid government-issued photo identification
(ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. Expired documents will
only be accepted if the document expired after March 1, 2020.
Please specify the document you are submitting:
☐ Driver’s License
☐ State-issued ID
☐ Passport
☐ Other (please specify): _______________________________________
In addition, you must sign the Statement of Educational Purpose provided below.
Statement of Educational Purpose
I certify that I _________________________________________________________ am the individual signing this
(Print Student’s Name)
Statement of Educational Purpose and that the Federal student financial assistance I may receive will only be used
for educational purposes and to pay the cost of attending Eastern Florida State College for 2019-2020.
_______________________________________ _______________
(Student’s Signature) (Date)
_______________________________________
(Student’s ID Number)
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
9
04/06/20
G. Certification and Signatures
Each person signing below certifies that all of the information
reported is complete and correct. The student and one parent
whose information was reported on the FAFSA must sign and date.
Student’s Original Signature (cannot be signed electronically) Date
Parent’s Original Signature (cannot be signed electronically) Date
H. Document Submission
You may submit this document by the following methods:
1. EFSC DOCUMENT DROPBOX (RECOMMENDED)
Print and complete this document (including the original signatures), scan the document, and upload the
document via the Document Dropbox in myEFSC.
2. BY MAIL
Mail your document to the Office of Financial Aid at:
Eastern Florida State College
Office of Financial Aid
Building 2, Room 209
1519 Clearlake Road
Cocoa, FL 32922
QUESTIONS?
Financial Aid Specialists are available by phone at 321-433-7339, and via e-mail at finaid@easternflorida.edu.
Eastern Florida State College is committed to equal access/equal opportunity in its programs, activities, and employment. For
additional information, visit Eastern Florida State College: easternflorida.edu/go/equity.
WARNING: If you purposely give
false or misleading information on
this worksheet, you may be fined,
sent to prison, or both.
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2019-20 Verification Dependent Student Form (Eastern Florida State College)

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Completed 21 July 2020

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