2019-20 Verification Worksheet
Your FAFSA was selected for a review process called verification. In the process, the campus will be comparing information from your FAFSA with
your Federal tax information, W-2 forms and/or other financial documents. The federal law states that the campus must ask for this information
before awarding financial aid. If there are differences between your FAFSA information and your financial documents, corrections will be made to
your FAFSA and your information will be reprocessed. You must complete, sign and submit this worksheet along with any documents requested
below no later than 30 days prior to the last date of the semester. We cannot continue processing your financial aid application until verification is
completed.
A.
STUDENT INFORMATION
Last Name First Name M.I. UH ID Number
Phone Number Date of Birth
FAMILY INFORMATION
DEPENDENT STUDENTS: You are considered a Dependent student if you were
required to provide your parent’s information on your FAFSA. Complete
sections A, B, C, and D. (NOTE: If your parents are divorced or separated, list
the family members of the parent you lived with more during the past 12
months or provided more financial support to you during the last 12
months.)
yourself,
your parent(s); including stepparent, and
your parents other children, if (a) your parents provide more than half of
their support from July 1, 2019 through June 30, 2020, or (b) the children
would be required to provide parental information when applying for
Federal student aid, and
other people if they now live with your parents, and your parents
provide more than half of their support and will continue to provide
more than half of their support from July 1, 2019 through June 30, 2020
INDEPENDENT STUDENTS: You are considered an Independent student if you
were not required to provide your parent’s information on your FAFSA.
Complete sections A, B, and D.
yourself,
your spouse, if married,
your children, if you provide more than half of their support from July 1,
2019 through June 30, 2020, and
other people if they now live with you, and you provide more than halfof
their support and will continue to provide more than half of their support
from July 1, 2019 to June 30, 2020
Write the names of family members in your or in your parents’ household according to the instructions above (if applicable). Also write the name of
the college for any family member, excluding your parent(s), who will be attending college at least half-time between July 1, 2019 and June 30,
2020, and will be enrolled in a degree, diploma, or certificate program. Attach a separate sheet if more space is needed.
Full Name Age Relationship College
Self
B.
STUDENTS (AND SPOUSES) TAX AND INCOME INFORMATION
1.
TAXRETURN FILERS COMPLETE THIS SECTION IF YOU FILED A TAX RETURN OR RECEIVED A WAGE& TAX STATEMENT FROM ONE OF THEFREELY ASSOCIATED STATES.
Student (and spouse) filed a 2017 Federal Tax Return and either used the IRS Data Retrieval Tool or will be using the IRS Data Retrieval
Tool to transfer IRS information to the FAFSA.
Student (and spouse) filed a 2017 Federal Tax Return but unable or chose not to use the IRS Data Retrieval Tool in FAFSA and have
attached; or will submit separately, a 2017 Federal Tax Return Transcript.
Student (and spouse) filed a 2017 tax document with either a U.S. Territory (Guam, American Samoa, U.S. Virgin Islands) or
Commonwealth (Puerto Rico and the Northern Mariana Islands) and have attached a 2017 transcript that was obtained at no cost from the
relevant taxing authority OR a copy of my signed tax document with proof of fees charged for an official transcript.
Student (and spouse) completed a 2017 foreign tax return or received a wage and tax statement from one of the Freely Associated
States (Federated States of Micronesia, Palau, and the Marshall Islands) and have attached a signed copy.
The University is committed to a policy of nondiscrimination on the basis of race, sex, gender identity and expression, age, religion, color, national origin, ancestry, citizenship, disability,
genetic information, marital status, breastfeeding, income assignment for child support, arrest and court record (except as permissible under State law), sexual orientation, national guard
absence, or status as a covered veteran. UH Title IX Coordinators' names and contact information are available at: https://www.hawaii.edu/titleix/help/coordinator/ and UH 504
Coordinators’ names and contact information are available at: https://www.hawaii.edu/offices/eeo/ada-504-coordinators/
UH HILO, UH WEST O‘AHU AND UH MĀNOA STUDENTS NEED TO CONTACT THEIR FINANCIAL AID OFFICE FOR CAMPUS SPECIFIC FORMS.
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WARNING: If you purposely give false or
misleading information on this worksheet,
you may be fined, be sentenced to jail, or
both.
STUDENT NAME: UH ID #/USERNAME:
2.
NON-TAX FILERS COMPLETE THIS SECTION IF YOU (AND SPOUSE) DID NOT FILE AND WERE NOT REQUIRED TO FILE A TAX RETURN WITH THE APPROPRIATE TAXING AUTHORITY. (IRS
Form 4506-T can be used to request the required document from the U.S. taxing authority)
If you (and/or spouse) did not file and/or are not required to file a 2017 Tax Return, list below your employer(s) and any income earned from work
in 2017. If you (and/or spouse) had no income earned from work for 2017, enter “0”. W-2/Wage Statement(s); if income was earned, and
documentation from the appropriate taxing authority to verify that you (and/or spouse) did not file must also be submitted.
Source (Use the W-2 form or other earnings statement)
2017 Amount (attach W-2/Wage Statement)
Attached is a Verification of Non-filing form from the appropriate taxing authority.
The Verification of Non-filing form from the appropriate taxing authority will be submitted separately.
I am not required to submit a Verification of Non-filing because I am the student who had to provide parent information on the FAFSA
C.
PARENT(S) TAX FORM AND INCOME INFORMATION (FOR DEPENDENT STUDENTS)
1.
TAXRETURN FILERS COMPLETE THIS SECTION IF YOU FILED A TAX RETURN OR RECEIVED A WAGE& TAX STATEMENT FROM ONE OF THEFREELY ASSOCIATED STATES.
Parent(s) filed a 2017 Federal Tax Return and either used the IRS Data Retrieval Tool or will be using the IRS Data Retrieval Tool to
transfer IRS information to the FAFSA.
Parent(s) filed a 2017 Federal Tax Return but unable or chose not to use the IRS Data Retrieval Tool in FAFSA and have attached; or will
submit separately, a 2017 Federal Tax Return Transcript.
Parent(s) filed a 2017 tax document with either a U.S. Territory (Guam, American Samoa, U.S. Virgin Islands) or Commonwealth (Puerto
Rico and the Northern Mariana Islands) and have attached a 2017 transcript that was obtained at no cost from the relevant taxing authority
OR a copy of my signed tax document with proof of fees charged for an official transcript.
Parent(s) completed a 2017 foreign tax return or received a wage and tax statement from one of the Freely Associated States (Federated
States of Micronesia, Palau, and the Marshall Islands) and have attached a signed copy.
2.
NON-TAX FILERS COMPLETE THIS SECTION IF YOU DID NOT FILE AND WERE NOT REQUIRED TO FILE A TAX RETURN WITH YOUR APPROPRIATE TAXING
AUTHORITY
. (IRS Form 4506-T can be used to request the required document from the U.S. taxingauthority)
If your parent(s) did not file and/or are not required to file a 2017 Tax Return, list below your parent(s) employer(s) and
any income earned from work in 2017. If your parent(s) had no income earned from work for 2017, enter “0”. W-2/Wage
Statement(s); if income was earned, and documentation from the appropriate taxing authority to verify that you (and/or
spouse) did not file must also be submitted.
Source (Use the W-2 form or other earnings statement)
2017 Amount (attach W-2/Wage Statement)
Attached is a Verification of Non-filing form from the appropriate taxing authority.
The Verification of Non-filing form from the appropriate taxing authority will be submitted separately.
D.
CERTIFICATION AND SIGNATURES: By signing this worksheet, we certify that all the information reported to qualify for
federal student aid is complete and correct. Electronic signature(s) or digital signature(s) will NOT be
accepted.
Student (required) Date
Parent (required for dependent student) Date
D
O NOT MAIL THIS WORKSHEET TO THE U.S. DEPARTMENT OF EDUCATION
RETURN THIS FORM ALONG WITH ANY OTHER REQUIRED DOCUMENTATION TO THE COMMUNITY COLLEGE CAMPUS THAT YOU WILL BE ATTENDING:
Community College
Email
Phone
Hawaiʻi Community College
hawccfao@hawaii.edu
(808) 934-2712
Honolulu Community College
honccfao@hawaii.edu
(808) 845-9116
Kapiʻolani Community College
kapfao@hawaii.edu
(808) 734-9537
Kauaʻi Community College
kauccfao@hawaii.edu
(808) 245-8360
Leeward Community College
lccfao@hawaii.edu
(808) 455-0606
University of Hawaiʻi Maui College
mauifa@hawaii.edu
(808) 984-3277
Windward Community College
wccfao@hawaii.edu
(808) 235-7449
UH HILO, UH WEST O‘AHU AND UH MĀNOA STUDENTS NEED TO CONTACT THEIR FINANCIAL AID OFFICE FOR CAMPUS SPECIFIC FORMS.
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Rev 04/2020
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