Financial Aid Office, 1620 Edward P Smith Dr, Aberdeen, WA 98520
www.ghc.edu/finaid (360) 538-4081 Fax: (360) 538-4293 finaid@ghc.edu
Revised: 02/19/2019
2019-2020 Independent Verification Worksheet
Your 2019-20 FAFSA was selected for review in a process called verification. Federal Regulations say that before
awarding Federal Student Aid, we must ask you to confirm the information you reported on your FAFSA. In this process,
the Financial Aid Office will compare your FAFSA with the information on this worksheet and any other required
documents. If there are differences, we may need to correct your FAFSA. You must complete and sign this worksheet,
attach required documents and submit them to the Financial Aid Office in order to be considered for financial aid funding.
Additional information may be required by the Financial Aid Office.
DO NOT LEAVE BLANK- READ AND COMPLETE ALL SECTIONS!
1. Student Information
Last Name First Name M.I. SSN
2. Household Chart
Use each chart below to list the people who are or will be in your household from July 1, 2019 through June
30, 2020.
2.a
Yourself
Your spouse, if you are married
Full Name Age Relationship Name of College (if attending)
Will be Enrolled at
Least Half Time in
College
self
Grays Harbor College
Yes
No
spouse
Yes
No
2.b
Your children, if you will provide more than half of their support from July 1, 2019, through June 30, 2020; OR if
the child would be required to provide parental information if they were completing a FAFSA for 2019–2020.
Include children who meet either of these standards, even if they do not live with you.
Full Name Age Relationship Name of College (if attending)
Will be Enrolled at
Least Half Time in
College
Child 1
Yes
No
Child 2
Yes
No
Child 3
Yes
No
Child 4
Yes
No
Child 5
Yes
No
2.c
Other people if they now live with you, AND you provide more than half of their support and will continue to
provide more than half of their support through June 30, 2020.
Full Name Age Relationship Name of College (if attending)
Will be Enrolled at
Least Half Time in
College
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
5I
3. 2017 Income Information
INSTRUCTIONS FOR 2017 TAX FILERS: Check the appropriate box below for both the student and/or spouse.
The best way to verify income is by using the IRS Data Retrieval Tool (DRT) that is part of the FAFSA.
I used the IRS Data Retrieval Tool (DRT) on the FAFSA.
I am attaching my 2017 IRS Tax Return Transcript.
I am attaching a signed copy of my 2017 Tax Return
I filed an amended 2017 Tax Return.
If you select this option you must submit a signed copy of your 1040X and a Tax Return Transcript or a signed copy of your
2017 Tax Return.
INSTRUCTIONS FOR 2017 NON-TAX FILERS: Complete this section if the student and/or spouse have not filed
and are not required to file a 2017 Income Tax Return with the IRS. See step 4 for options on requesting a 2017
Verification of Non-Filing Letter.
Non-Filing Status (Select one option)
I am attaching my IRS Letter of Non-Filing Status because I did not or was not required to file a 2017 Tax Return.
I am unable to obtain an IRS Letter of Non-Filing Status and have attached documentation (i.e. screen shots)
that verifies I have attempted to access the Letter of Non-Filing Status from the IRS website.
2017 Earnings Information (Select one option)
I did not have earnings in 2017.
I had earnings in 2017. You must list your employer(s) and income earned below AND attach W-2 form(s). All
W-2 forms must be provided.
4. IRS Tax Transcript or Verification of Non-filing Letter Request Options
Get a Transcript either ONLINE or by MAIL – Go to www.irs.gov, click “Get Your Tax Record”. Click
“Get Transcript Online” or “Get Transcript by Mail”.
o You must use the form 4506T if your address has changed since you last filed.
Automated Telephone Request – 1-800-908-9946 (Only primary taxpayer on return can use this option)
5. Student – Identity Verification (Check the appropriate box)
I am appearing in-person with valid, unexpired government-issued photo ID (such as a driver’s license, state
identification card, military ID or passport). The Financial Aid Office will make a copy.
I am attaching a copy of my valid, unexpired government-issued photo ID (such as a driver’s license, state
identification card, military ID or passport) this MUST BE ACKNOWLEDGED in the notary statement in section 7.
6. High School Completion Status
(Check the correct box and provide the required documentation)
High School Diploma: Attach a copy of your high school diploma or high school transcript indicating your
graduation date.
GED: Attach a copy of your GED certificate or GED transcript.
Home School Graduate: Attach a copy of your home school completion transcript (or equivalent), signed by your
parent/guardian.
Copy of your high school transcript AND a signed statement from your high school counselor stating that,
although you didn’t graduate, you did excel academically in high school.
Copy of college transcript showing successful completion of at least a 2-year program fully acceptable toward a
bachelor’s degree.
Employer
Earnings/Income
7. Student – Statement of Educational Purpose
(Check the appropriate box and follow the instructions)
I am appearing in-person to sign the statement below. (Signature MUST be witnessed by a Financial Aid staff
member.)
I am unable to appear in-person to submit the statement below and have had the statement notarized.
I certify that I, ___________________________ am the individual signing this Statement of Educational Purpose and that the
(student’s name)
federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending
Grays Harbor College for 2019-2020.
FAO
Student Signature______________________________ Date__
_____________
Verification
Not
ary’s Certificate of Acknowledgement
Sta
te of_________________________________ City/County of __________________________________________________
On ______
_______________, before me, ______________________________________________________________________,
(Date) (Name of Notary)
Per
sonally appeared, ___________________________________________, and provided to me on basis of satisfactory evidence
(Printed name of signer)
of ide
ntification____________________________________________ to be the above-named person who signed the foregoing
(Type of unexpired government-issued photo ID provided)
instr
ument.
WIT
NESS my hand and official seal:
__________
______________________________________
(Notary’s Signature) (seal)
My commission expires on __________________________
(date)
8. Certification and Signature
By signing this worksheet I certify that all of the information reported on it is
complete and correct.
Student Signature Date
WARNING: If you purposely give false or misleading information
on this worksheet, you may be fined, sentenced to jail, or both.