CONTINUED ON REVERSE
2019-2020
Dependent Verification Worksheet (DV1/DV5)
STUDENT NAME:
____________________________________________________________ WCC ID #: ______________________________
ADDRESS: _________________________________________________________________________________________________________________
STREET OR PO BOX CITY STATE ZIP
Your 2019-2020 FAFSA was selected for review in a process called verification. Federal law states that the Financial Aid Office has
the right to confirm the information that was reported before awarding and/or disbursing federal student aid. We will compare the
information reported on the FAFSA for you and your parent(s) with the information reported on this worksheet and any other required
documentation. PLEASE NOTE – Your eligibility for financial aid cannot be determined until the verification process has been
completed.
INSTRUCTIONS: You, and a parent** whose information was included on the FAFSA, must complete this worksheet in blue
or black ink, attach any required documentation, sign, and submit the completed package to the WCC Financial Aid Office.
**Grandparents, foster parents, legal guardians, widowed stepparents, aunts, uncles, and siblings are not considered parents on this
form unless they have legally adopted you. If your legal parents are married to each other, OR are not married to each other AND live
together, answer the questions for each of them. If your parent was divorced/widowed and then remarried, you are required to include
information for your stepparent. If there are any discrepancies between the information reported on the FAFSA and the documents
submitted to our office, your signature on this form authorizes our office to make the appropriate corrections to
your FAFSA.
Additional information may be needed to complete your file. If you have any questions about the verification process, contact the
Financial Aid Office as soon as possible to avoid a delay in processing your request for financial aid.
A. PARENTS’ HOUSEHOLD SIZE
NOTE: The following guidelines apply to DEPENDENT students only. (Independent students should complete the IV1/IV5 form)
1. IN THE SPACES BELOW, LIST THE NAMES OF ALL MEMBERS OF YOUR PARENTS HOUSEHOLD INCLUDING:
The student
The parent(s) (including a stepparent) even if the student doesn’t live with the parent(s);
The parents other children IF the parent(s) will provide more than half (51%+) 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 when completing a FAFSA
for 2019-2020. Include children who meet either of these standards, even if a child does not live with the parent(s).
Other people ONLY if they now live with the parent(s) AND the parent(s) provide more than half (51%+) of the other
person’s support* AND will continue to provide more than half (51%+) of that person’s support* through June 30, 2020.
* Support includes money, gifts, loans, housing, food, clothing, transportation, medical/dental care, college tuition, etc.
**Additional documentation may be required to prove support of dependents other than the parent’s spouse or children.
2. NUMBER IN COLLEGE: In the last column below, provide the name of the college for any household member who is, or will be,
enrolled at least half time in a degree, diploma, or certificate program any time between July 1, 2019, and June 30, 2020.
EXCEPTION
-
Do not include parents’ as college students.
FULL NAME OF HOUSEHOLD MEMBER AGE
RELATIONSHIP TO
STUDENT
COLLEGE ATTENDING
2019-2020
Self
Wayne Community College
~If more space is needed, attach a separate page that includes the student’s name and WCC ID#~
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.
IMPORTANT: If your parent(s) were MARRIED or REMARRIED on the day you signed and submitted the FAFSA, you must
answer all tax and income questions for both parents and/or step-parent.
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. In most cases, no further documentation is needed to verify 2017 income information that was transferred into the
student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.
B. TAX FILING STATUS
STUDENT (check ONE only)
PARENT(S) (check ONE only)
The student filed a 2017 federal tax return AND used or will
use the IRS DATA RETRIEVAL TOOL to transfer tax
information into the FAFSA. {Skip to section D}
The parent(s) filed a 2017 federal tax return AND used or
will use the IRS DATA RETRIEVAL TOOL to transfer tax
information into the FAFSA. {Skip to section D}
The student filed a 2017 federal tax return but did not and
will not use the IRS Data Retrieval Tool. A signed copy of
the 2017 IRS TAX RETURN TRANSCRIPT* is attached.
{Skip to section D}
The parent(s) filed a 2017 federal tax return but did not and
will not use the IRS Data Retrieval Tool. A copy of the
2017 IRS TAX RETURN TRANSCRIPT(S)* signed by the
parent(s) is attached. {Skip to section D}
The student did not file a 2017 federal tax return. Complete
the NON-TAX FILERS STATEMENT in section C below.
The parent(s) did not file a 2017 federal tax return. The
parent(s) is required to complete the NON-TAX FILER’S
STATEMENT in section C.
*REQUEST IRS TAX RETURN TRANSCRIPTS @ WWW.IRS.GOV
C. NON-TAX FILER’S STATEMENT (complete this section ONLY if the student OR the student’s parent(s) did not file a 2017 IRS tax return)
IMPORTANT: Non-tax filing parents of dependent students are required to submit a VERIFICATION OF NON-FILING letter (available
via www.irs.gov). The letter must be dated on or after October 1, 2018, and be signed by the individual named in the letter.
**Remember to include the student name and WCC ID# on all documents submitted.
STUDENT (check ONE only)
PARENT(S) (check ONE only)
The student was not employed and had no income earned
from work in 2017.
Neither parent was employed, and neither had income
earned from work in 2017
The student was employed and earned income from
working in 2017 but DID NOT, WILL NOT, and is NOT
REQUIRED to file a federal tax return. ALL employers and
earned income amounts are listed below. Copies of ALL
W-2’s, 1099’s, and/or other statements of income
earned from working in 2017 are attached.
One or both parents were employed and earned income
from working in 2017 but DID NOT, WILL NOT, and were
NOT REQUIRED to file a federal tax return. ALL employers
and earned income amounts are listed below. Copies of
ALL W-2’s, 1099’s, and/or other statements of income
earned from working in 2017 are attached.
NAME OF EMPLOYER
STUDENT 2017
EARNINGS
W-2 or 1099
PROVIDED?
PARENT 2017
EARNINGS
W-2 or 1099
PROVIDED?
Example: XYZ Department Store 0 N/A $7000 Yes
~If more space is needed, attach a separate page that includes the student’s name and WCC ID#~
D. CERTIFICATION AND SIGNATURES
, I certify that all information reported on this form and any documentation provided is true and complete.
__________________________________________________ _______________________
STUDENT SIGNATURE (REQUIRED) DATE
__________________________________________________ _______________________
PARENT SIGNATURE (REQUIRED)
DATE
WARNING: If you purposely provide false or misleading information to obtain financial aid, you may be fined, sentenced to jail, or both.
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