Fillable 2019-2020 Independent Verification Worksheet (Alvin Community College)

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2019-2020 Independent Verification Worksheet (Alvin Community College)

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The 2019-2020 Independent Verification Worksheet (Alvin Community College) form is 2 pages long and contains:

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  • 6 check-boxes
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File type: PDF

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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 Independent 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 any 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 household. Include yourself, your spouse and all children (even if they do not live
with you) if you will provide more than half of their support from July 1, 2019 through June 30, 2020. Also include
other people if you provide MORE THAN HALF of their support and will continue to provide more than half of their
support through June 30, 2020. Also include unborn child(ren), if the child(ren) 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, 2019
– June 30, 2020
/ /
Self
Alvin Community College
/ / Spouse
/ /
/ /
/ /
/ /
/ /
/ /
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 the 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:
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.
OR
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 click on the “Get a transcript” link.
Please request the “IRS Tax Return Trans
cript” 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
Self $
Spouse $
I have other untaxed income.
I will submit the Additional Income Worksheet
E. Certification & Signature
WARNING:Ifyoupurposelygivefalseormisleadinginformationonthisworksheet,youmaybefined,besentencedtojail,orboth.
StudentSignature:________________________________
_________________Date:_________________
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2019-2020 Independent Verification Worksheet (Alvin Community College)

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Completed 27 July 2020

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