Fillable 20192020 Aggregate Verification Worksheet V5-Dependent Student

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20192020 Aggregate Verification Worksheet V5-Dependent Student

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2019–2020 Aggregate Verification Worksheet
V5-Dependent Student
Your 2019–2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called
“Verification”. The Financial Aid Office at your college must compare information from your FAFSA with information
you provide on this worksheet and with any other required documents. If there are differences, your Financial Aid
Office may require additional documentation and your FAFSA information may need to be corrected. You will not
receive federal financial aid until all verification requirements are met and the necessary corrections made.
What You Should Do
1. If you or your parent(s) are tax filers, obtain a 2017 IRS Tax Return Transcript for yourself and your
parent(s). Request an IRS Tax Return Transcript online at www.irs.gov/Individuals/Get-Transcript
or by phone at
1-800-908-9946. Make sure you select an IRS Tax Return Transcript and NOT the IRS Tax Account Transcript. Be
sure to specify tax year 2017 when making your request. In place of the transcript, the Financial Aid Office can
accept a complete signed copy of a preparer’s 2017 Federal Income Tax Return (Form 1040, 1040A or
1040EZ) that was submitted to the IRS. Important Note: If you used the IRS Data Retrieval Tool to transfer
your 2017 income data into your FAFSA, you may not have to submit the IRS Tax Return Transcript.
2. If your parents had income earned from work in 2017, but did not and were not required to file a tax return, they
must provide a 2017 Verification of Non-Filing Letter dated on or after October 1, 2018. They may request a
Verification of Non-Filing Letter at www.irs.gov/Individuals/Get-Transcript
or by phone at 1-800-908-9946. Both
you and your parents must provide copies of W-2 forms issued by your employers for all income earned from
work in tax year 2017 that was not reported on a tax return.
3. Complete Sections A-D of this worksheet – you and one of your parents must sign the Section E certification on
page 3 of the worksheet. Collect the documents required for Section F on page 3 but do NOT complete that
section in advance.
4. Submit the completed worksheet, tax return transcript(s) and any other required documents to the Financial Aid
Office at your college. You will complete Section F in person at that time.
A. Student’s Information
Student’s Last Name First Name M.I. Student’s Social Security Number
Student’s Street Address (include apt. no.) Student’s CUNYfirst ID / Empl ID
City State Zip Code Student’s Date of Birth
Student’s Home Phone Number (include area code) Student’s Email Address
B. Parents’ Household Information
List the people your parent(s) will support between July 1, 2019 and June 30, 2020. Include:
• Yourself and your parent(s)
• Your parents’ other children if (a) your parent(s) provide more than half of their support, or (b) if the
other children would be required to provide parental information were they to complete a FAFSA for 2019–
2020. Include children who meet either of these standards, even if they do not live with your parent(s).
• Other people if they now live with your parent(s), and your parent(s) now provide more than half of their
support and will continue to provide more than half of their support through June 30, 2020.
Write the name of the college below for any household member, excluding your parent(s), who will be enrolled at
least half time in a degree, diploma, or certificate program at an eligible postsecondary educational institution any
time between July 1, 2019 and June 30, 2020.
If more space is needed, attach a separate page with student’s name and the last 4 digits of student’s SSN at the top.
Full Name
Example: Jane Smith
Age
18
Relationship
Sister
College
State University
Will be Enrolled at
Least Half Time
Yes
Self
2019-20 Aggregate Verification Worksheet V5-Dependent Student Page 1 of 3
Student Name: Student SSN: XXX-XX- ____ ____ ____ ____
C. Student’s Income Information to Be Verified
NOTE: If you filed an amended 2017 IRS tax return, you may be required to submit additional documentation to
the Financial Aid Office at your college.
Check the box that applies:
I used the IRS Data Retrieval Tool in FAFSA-on-the-Web to transfer 2017 IRS income tax information into my
FAFSA. [The income tax information from your FAFSA will be used to complete the verification process.]
I did not (or could not) transfer my 2017 income information to the FAFSA using the IRS Data Retrieval Tool.
I have attached a copy to this worksheet of my 2017 IRS Tax Return Transcript or a signed preparer’s
copy of the 2017 Federal Income Tax Return (Form 1040, 1040A or 1040EZ) that was submitted to the
IRS.
I have not filed (and am not required to file) a 2017 federal income tax return and I had no income earned
from work in 2017.
I have not filed (and am not required to file) a 2017 federal income tax return, but I had income earned from
work in 2017 as listed below. [List every employer and the amounts earned in 2017, even if they did not issue
an IRS Form W-2. Attach copies of all 2017 IRS Forms W-2 that were issued to you by employers.]
Only complete this grid if you are a non-tax filer that had earned income in 2017. If more space is needed, attach a
separate page with student’s name and the last 4 digits of student’s SSN at the top.
Employer’s Name 2017 Amount Earned 2017 W2 Attached?
Example: ABC Company $1367.75 Yes
D. Parent(s)’ Income Information to Be Verified
NOTE: Provide the requested income information for each parent/stepparent listed in Section B of this
worksheet. Notify your Financial Aid Office if your parents had a change in marital status after December
31, 2017. If your parent(s) filed (or will file) an amended 2017 IRS tax return, they may be required to
submit additional documentation to the Financial Aid Office.
Check the appropriate box (or boxes):
I/we used the IRS Data Retrieval Tool in FAFSA-on-the-Web to transfer 2017 IRS income tax information into
the FAFSA. [The income tax information from the FAFSA will be used to complete the verification process.]
I/we did not (or could not) transfer my/our 2017 income information to the FAFSA using the IRS Data
Retrieval Tool. I/we have attached a copy to this worksheet of my/our 2017 IRS Tax Return Transcript or
a signed preparer’s copy of the 2017 Federal Income Tax Return (Form 1040, 1040A or 1040EZ) that
was submitted to the IRS. [Note: if your parents filed a joint tax return, but you reported your parent’s
marital status on the FAFSA as separated, divorced or widowed, you must include copies of all IRS Form W-2s
with the tax transcript.]
I/we have not filed (and are not required to file) a 2017 federal income tax return and I/we had no income
earned from work in 2017. I/we have each attached a 2017 Verification of Non-Filing Letter to this
worksheet.
I/we have not filed (and are not required to file) a 2017 federal income tax return but I/we had income earned
from work in 2017 as listed below. I/we have each attached a 2017 Verification of Non-Filing Letter to
this worksheet. [List every employer and the amounts earned in 2017, even if an IRS Form W-2 was not
issued. You must attach copies of all 2017 IRS Forms W-2 that were issued to you by your employers.]
Only complete this grid if your parent(s) were non-tax filer(s) that had earned income in 2017. If more space is
needed, attach a separate page with student’s name and the last 4 digits of student’s SSN at the top.
Employer’s Name 2017 Amount Earned 2017 W2 Attached?
Example: ABC Company $1367.75 Yes
2019-20 Aggregate Verification Worksheet V5-Dependent Student Page 2 of 3
Student Name: Student SSN: XXX-XX- ____ ____ ____ ____
E. Certification and Signatures – Student and one parent must sign
We certify that all the information reported on this worksheet is complete and correct. We further understand
that if we purposely give false or misleading information, we could be fined, jailed, or both.
Student Signature Date
Parent Signature Date
Do not complete Section F below in advance. You must complete and sign Section F IN PERSON at the
Financial Aid Office at your college.
F. Identity Verification and Statement of Educational Purpose
You have been selected by the U.S. Department of Education to verify your identity and educational plans. You must
appear in person at the Financial Aid Office at your college and present a piece of valid government-issued
identification to a financial aid representative. The representative will review and copy this piece of identification
which will be maintained in your student file.
Statement of Educational Purpose
I certify that I, _____________________________________________________________________________
(Print Name)
am the individual signing this Statement of Educational Purpose and that the federal student financial assistance I
may receive will only be used for educational purposes and to pay the cost of attending
________________________________________________________________ for 2019-2020.
(Name of CUNY Institution Attending)
Student’s Signature: ____________________________________________ Date: _______________________
OFFICE USE ONLY- DO NOT WRITE BELOW
1. Proof of Identity
The above-named student has presented valid government-issued photo identification such as a state driver’s license,
non-driver’s license or passport which verifies his or her identity.
NOTE: An unexpired valid government-issued photo identification is one issued by the U.S. government, any of the 50
States, the District of Columbia, the Commonwealth of Puerto Rico, a federally recognized American Indian and Alaska
Native Tribe, or other U.S. territory as outlined in the Federal Register.
FA Certifying Officer’s Signature Date Received Type of Valid ID Collected
2. Completion of High School or the Equivalent
The above-named student has submitted a final high school transcript or other acceptable documentation to the
appropriate CUNY office that shows evidence of graduation from an accredited high school or educational institution,
state-issued general education equivalency (GED), or evidence of home schooling.
FA Certifying Officer’s Signature Date Received
2019-20 Aggregate Verification Worksheet V5-Dependent Student Page 3 of 3
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Completed 26 July 2020

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