STUDENT FINANCIAL SERVICES
2020-2021 DEPENDENT CUSTOM
VERIFICATION WORKSHEET
D4
Your 2020-2021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law
says that before awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify
that you provided correct information, we will compare your FAFSA with the information on this institutional verification document
and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You and a
parent whose information was reported on the FAFSA must complete and sign this institutional verification document, attach an y required
documents, and submit the form and other required documents to us. We may ask for additional information. If you have questio ns about
verification, contact us as soon as possible so that your financial aid will not be delayed.
Deadline: To determine your eligibility for federal and/or state funds, your verification documents must be received by our office no
later than August 16, 2021 or 120 days after your last date of enrollment, whichever comes first. Failure to do so by the stated
deadline will result in a loss of eligibility for the current academic year.
MTC must review the requested information, under the financial aid program rules (34 CFR, Part 668).
A.
STUDENT INFORMATION
Print the information requested below:
Last Name
First Name
M.I.
MTC ID
Address (include apt. no.)
MyMTC Email Address
City
State
Zip Code
Student Date of Birth
Student Home Phone Number (include area code) Student Alternate or Cell Phone (include area code)
B.
FAMILY INFORMATION
List below the people in the parent’s household, include:
>
The student
> The parents (including a stepparent) even if the student doesnt live with the parents.
> The parents other children if the parents will provide more than half of the childrens support from July 1, 2020, through
June 30, 2021, or if the other children would be required to provide parental information if they were completing a FAFSA
for 2020-2021. Include children who meet either of these standards, even if a child does not live with the parents.
> Other people if they now live with the parents and the parents provide more than half of the other persons support, and
will continue to provide more than half of that persons support through June 30, 2021.
Number in college: Include in the space below information about any household member, excluding the parents, who is, or 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, 2020, and June 30, 2021, and include the name of the college.
If more space is needed, provide a separate page with the student’s name and ID number at the top.
Full Name
Age
Relationship*
College Attending in 2020-2021
Will be enrolled at
least half time?
1.
Self
Midlands Technical College
Yes/No
2.
3.
4.
5.
6.
Note: We may require additional documentation, if we have reason to believe that the information regarding the household members
enrolled in eligible postsecondary educational institutions is inaccurate.
*If the relationship listed is not a parent, sibling or child, you must also complete Section D of the Clarification Statement explaining the
reason this individual should be included in your household size.
C.
HIGH SCHOOL COMPLETION STATUS
Provide one of the following documents to indicate the students high school completion status when the student begins college in
2020-2021:
I have previously submitted my official high school transcript or GED certificate to Midlands Technical College.
Attached is a copy of my documentation. (Official high school transcript that shows the date the diploma was awarded,
official GED certificate or copy of High School Diploma.)
For students who completed secondary education in a foreign country, a copy of the “secondary school leaving certificate
or similar document.
A state certificate or transcript received by a student after the student passed a state -authorized examination that the
state recognizes as the equivalent of a high school diploma (GED test, HiSET, TASC or other state authorized examination.)
An academic transcript that indicates the student successfully completed at least a two -year program that is
acceptable for full credit toward a bachelor’s degree.
I was homeschooled in a state where state law requires the student to obtain a secondary school completion credential for
homeschooling (other than a high school diploma or its equivalent); a copy of that credential is attached.
I was homeschooled in a state where state law does not require the student to obtain a secondary school completion
credential for homeschooling (other than a high school diploma or its recognized equivalent). A transcript, or the equivalent,
signed by the student’s parent or guardian, that lists the secondary school courses the student completed and includes a
statement that the student successfully completed a secondary school education in a homeschool setting is attached.
I do not have a high school diploma, GED nor have I completed homeschooling requirements.
D.
SIGN THIS WORKSHEET
I certify that all of the information reported is complete and correct. The student and one parent whose information was reported on
the FAFSA must sign and date this worksheet. WARNING: If you purposely give false or misleading information, you may be fined,
sentenced to jail, or both.
Students Signature (Required) Date
Parents Signature (Required) Date
Return completed form and all copies of requested documents to:
Student Financial Services Office i Midlands Technical College i PO Box 2408 i Columbia, SC 29202
SD-20-6284B-02-20
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signature
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