2019-2020 VERIFICATION
HOUSEHOLD SIZE INFORMATION
Please Print and Use Ink DO NOT LEAVE ANY LINE ON THIS FORM BLANK
STUDENT INFORMATION
Student Name: SSN/Banner I.D. #:
Your application was selected for review in a process called “Verification.” In this process, MSU Northern will be comparing information
from your application with your financial documents. The law says we have the right to ask you for this information before awarding Federal
aid. Complete this verification form and submit it to the MSU Northern Financial Aid Office as soon as possible, so your financial aid won’t be
delayed.
FAMILY INFORMATION
List the people that you (and your parents) will support between
July 1, 2019 and June 30, 2020. Include:
Yourself and your spouse, if married
Your dependent children
A. If you provide more than half their support -OR-
B. If child can answer ‘No’ to all the dependency
questions on the FAFSA (Questions 46-58)
Your parents, if you are dependent
Your parent’s dependent children
Include other people as part of your family only if:
They lived with you (or your parents) and received more than
half their support from you (or your parents) at the time you
completed your student aid application AND They will
continue to get more than half their support from you (or your
parents) from July 1, 2019 through June 30, 2020.
Write the names of all family members including yourself. Also write in the name of the college for any family member who will be attending
college at least half-time between July 1, 2019 and June 30, 2020, and will be enrolled in a degree or certificate program. If you need more
space, attach a separate page.
FULL NAME
AGE
RELATIONSHIP
COLLEGE
Example: Janet Jones
25
Self
MSU Northern
AUTHORIZATION
By signing this worksheet, we certify that all the information reported to qualify for Federal student aid is complete and correct.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail or both.
Student’s Signature Date Spouse’s Signature Date
Father’s (Stepfather’s) Signature Date Mother’s (Stepmother’s) Signature Date
Return this form to: Financial Aid Office; MSU Northern; PO Box 7751; Havre, MT 59501
MSU Northern does not discriminate on the basis of race, color, national origin, age, sex, or disability.
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