CONTINUED ON REVERSE
2019-2020
Independent Verification Worksheet (IV1/IV5)
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 spouse (if married) 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: Complete this worksheet in blue or black ink, attach any required documentation, sign, and submit the
completed package to the WCC Financial Aid Office.
**If you were married on the day you signed and submitted your FAFSA, you are required to include information for your spouse. 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, please contact
the Financial Aid Office as soon as possible to avoid a delay in processing your request for financial aid.
A. STUDENT’S HOUSEHOLD SIZE
NOTE: The following guidelines apply to INDEPENDENT students only. (Dependent students should complete the DV1/DV5 form)
1. IN THE SPACES BELOW, LIST THE NAMES OF ALL MEMBERS OF THE STUDENT’S HOUSEHOLD INCLUDING:
The student;
The student’s spouse (if the student is married);
The student’s or spouse’s children IF the student or spouse will provide more than half (51%+) of the children’s support*
from July 1, 2019 through June 30, 2020, even if the children do not live with the student;
Other people ONLY if they now live with the student AND the student or spouse provides 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 student’s spouse and 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.
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 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 you were married on the day you signed and submitted the FAFSA, you must answer all tax and income
questions for you AND your spouse. **If you were not married or were separated, please ignore all references to “spouse”.
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 (select ONE only)
SPOUSE (select 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 student and spouse filed a joint 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 spouse filed a separate 2017 federal tax return. A copy
of the 2017 IRS TAX RETURN TRANSCRIPT* signed by
the spouse 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 spouse did not file a 2017 federal tax return. The
spouse is required complete the NON-TAX FILER’S
STATEMENT in section C below and to sign this form in
section D.
*REQUEST IRS TAX RETURN TRANSCRIPTS @ WWW.IRS.GOV
C. NON-TAX FILERS STATEMENT
(complete this section ONLY if the student OR student’s spouse did not file a 2017 IRS tax return)
IMPORTANT: Independent non-tax filers 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 (select ONE only) SPOUSE (select ONE only)
The student was not employed and had no income earned
from work in 2017.
The spouse was not employed and had no 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.
The spouse 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.
NAME OF EMPLOYER
STUDENT 2017
EARNINGS
W-2 or 1099
PROVIDED?
SPOUSE 2017
EARNINGS
W-2 OR 1099
PROVIDED?
XYZ Department Store
$1400 Yes N/A N/A
~If more space is needed, attach a separate page that includes the student’s name and WCC ID#~
D. CERTIFICATION AND SIGNATURES
By
signing below, I certify that all information reported on this form and any documentation provided is true and complete.
__________________________________________________
STUDENT SIGNATURE (REQUIRED)
_______________________________________________________
SPOUSE SIGNATURE (REQUIRED FOR NON-TAX FILERS)
_____________________
DATE
_______________________
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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