Return this form and documents
to:
Financial Aid Office | 3110 Mustang Rd. Alvin, TX 77511 | (281) 756-3524 Fax(281) 756-3840 |
fa@alvincollege.edu
2019-2020 Dependent Verification Worksheet
The U.S. Department of Education has selected your file for a process called “Verification.” Alvin Community College will be
comparing information from your application with your financial documents. If there are differences between your application
information and the documents you submit, your application may need to be reprocessed. Your federal financial aid may not be
available to you until all verification requirements have been met and necessary corrections have been made. This worksheet
will be considered incomplete if there are missing documents. Your financial aid awards will be available via your POD account
once the process is complete.
A. Student Information
Last Name First Name Middle Initial
ACC ID ACC Email
Date of Birth
Cell Phone Number
B. Household Information
List names of all persons in your parent(s) household. Include yourself, your pa
rents and their other children (even if
they do not live with your parents) if your parents will provide more than half of their support from July 1, 2019 through
June 30, 2020. Also include other people if they now live with your parent(s) and your parent(s) provide more than half
of their support and will continue that support through June 30, 2019. Also include child(ren) that will be born before
June 30, 2020.
Full Name Birthdate Age
Relationship to the
Student
Indicate college name if the
individual will attend at
least half-time between
July 1, 2019June 30, 2020
/
/
Self
Alvin Community College
/
/
Parent 1
/
/
Parent 2
/
/
/
/
/
/
/
/
/
/
/
/
C. Other Information to be Verified
1) Check here if anyone in your household (listed in Section B) received benefits from the
Supplemental Nutrition Assistance Program or SNAP (formerly known as food stamps) any
time during 2016 or 2017. Please submit a copy of the SNAP/Lonestar card or award letter from
the issuing agency for Food Stamps.
2)
If one of the parents included above paid child support in 2017 because of a divorce or
separation, or as a result of a legal requirement, please complete the following information:
Name of Person Who
Paid Child Support
Name of Person to Whom
Child Support was Paid
Name of Child for Whom
Support Was Paid
Amount of
Child
Support Paid in
2017
Return this form and documents
to:
Financial Aid Office | 3110 Mustang Rd. Alvin, TX 77511 | (281) 756-3524 Fax(281) 756-3840 | fa@alvincollege.edu
D. Student’s Tax Forms & Income Information (All Applicants)
Check the following which pertains to you
Yes, I did file or will file a 2017 tax return. Please check ONE of the following:
OR
I, the student, have used the IRS DRT in FAFSA on the Web to transfer 2017 IRS income
tax return information into my FAFSA, either initially or by making a correction to my FAFSA.
I, the student, am unable or chose not to use the IRS DRT in FAFSA on the Web, and instead
will provide the school a 2017 IRS Tax Return Transcript(s) or signed copies of my 2017 income tax
return.
To obtain a 2017 IRS Tax Return Transcript, go to www.IRS.gov and clic
k on the Get a tax
transcript” link. Please request the “IRS Tax Return Transcript and not the “Account
Transcript.” (Electronic filers may request the Transcript within 2–3 weeks after filing / 8-11 weeks for paper
filers.)
No, I did not and am not required to file a 2017 federal income tax return:
Please provide W-2’s for each employer, if applicable, and list any employers and income received in 2017:
Employer(s) (IF YOU DID NOT FILE A 2017 FEDERAL INCOME TAX RETURN) 2017 Income
Student $
I have other untaxed income.
I will submit the Additional Income Worksheet
E. Parent(s) Tax Forms & Income Information (Dependent Students)
Check the following which pertains to you
No, I did not and am not required to file a 2017 federal income tax return:
Please provide W-2’s for each employer, if applicable, and list any employers and income received in 2017:
Employer(s) (IF YOU DID NOT FILE A 2017 FEDERAL INCOME TAX RETURN) 2017 Income
Parent 1 $
Parent 2 $
I have other untaxed income.
I will submit the Additional Income Worksheet
F. Certification & Signature
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
Student
S
i
gnature:
Date:
Parent
Signature:
Date:
Yes, I did file or will file a 2017 tax return. Please check ONE of the following:
I, the parent, have used the IRS DRT in FAFSA on the Web to transfer 2017 IRS income
tax return information into my FAFSA, either initially or by making a correction to my FAFSA.
OR
I, the parent, am unable or chose not to use the IRS DRT in FAFSA on the Web, and
instead
will
provide the school a 2017 IRS Tax Return Transcript(s) or signed copies of my 2017 income tax
return. To obtain a 2017 IRS Tax Return Transcript, go to www.IRS.gov and click on the “Get a transcript”
link. Please request the “IRS Tax Return Transcript” and not the “Account Transcript.” (Electronic filers
may request the Transcript within 2–3 weeks after filing / 8-11 weeks for paper filers.)
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