2020-2021 Dependent
V4 Custom Verification Worksheet
Feather River College Financial Aid Office 570 Golden Eagle Avenue, Quincy CA 95971
Phone (530) 283-0202 ext 603 Fax (530) 283-4659 Email: financialaid@frc.edu
www.frc.edu/financialaid
DV4W21
Page1
Your FAFSA application has been selected for a process called verification. Please complete all parts of this worksheet and return to the Financial Aid
Office. Note: incomplete forms will delay processing.
B. Household InformationList all members in your parents’ household. Attach an additional sheet if necessary.
Please include: yourself, even if you don’t live with your parents, your parents/step-parent (if your parent is remarried you must include
your step-parent), your parents’ other children (even if they do not live with your parents), siblings, and individuals who will receive more
than half of their support from your parents between July 1, 2020 and June 30, 2021.
Full Name
Relationship to
Student
Age
Enrolled in College
at least half-time
(check one)
College
Self
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
C. Tell us about your 2018 tax filing status
Student’s Filing Status (select only one)
I filed my 2018 return and successfully used the IRS Data
Retrieval Tool via the FAFSA.
Tax transcript not required.
I filed my 2018 return and chose not to or, I am unable to
use the IRS Data Retrieval Tool.
Submit your 2018 IRS Tax
Return Transcript.
I amended my taxes after originally filing my 2018 return
and will submit:
o 2018 IRS Tax Return Transcript
o 2018 Signed IRS 1040X form
I did not and I am not required to file a federal tax return. I
was not employed and earned no income from work in
2018.
Submit 2018 IRS Verification of Non-filing Letter*
I did not and I am not required to file a federal tax return. In
2018, I earned $__________ from the source(s) listed
below:
Submit 2018 IRS Verification of Non-filing Letter
NON-FILERS ONLY TO FILL OUT BOX BELOW*
Employers Name
2018 Earned
Amount
IRS W-2 Attached
Yes
No
Yes
No
Yes
No
Attach all W-2s issued to you in 2018
Parent(s) Filing Status (select only one)
My parent(s) filed their 2018 return and successfully used
the IRS Data Retrieval Tool via the FAFSA.
Tax transcript
not required.
My parent(s) filed their 2018 tax return and chose not to or,
were not able to use the IRS Data Retrieval Tool.
Submit
parent’s 2018 IRS Tax Return Transcript.
My parent(s) amended their taxes after originally filing their
return and will submit:
o 2018 IRS Tax Return Transcript
o 2018 Signed IRS 1040X form
My parent(s) did not and is/are not required to file a federal
tax return. My parent(s) were not employed and earned no
income from work in 2018.
Submit 2018 IRS Verification of
Non-filing Letter
My parent(s) did not and is/are not required to file a federal
tax return. In 2018, my parent(s) earned $___________
from the source(s) listed below:
Submit 2018 IRS Verification of
Non-filing Letter
NON-FILERS ONLY TO FILL OUT BOX BELOW*
Employers Name
2018 Earned
Amount
IRS W-2 Attached
Yes
No
Yes
No
Yes
No
Attach all W-2s issued to your parent(s) in 2018
D. Certification and Signatures Each person signing this worksheet certifies that all of the information reported on it is complete
and correct. The student and one parent whose information was reported on the FAFSA must sign and date. Warning! If you
purposely give false or misleading information you may be fined, sentenced to jail, or both.
This worksheet must be signed and dated to be valid. Electronic and/or digital signatures are not valid.
Student Signature: _____________________________________________________ Date: ___________________
Parent Signature: ______________________________________________________ Date: ___________________
A. Student Information
Student’s Name: ________________________________________________ FRC ID: ________________________
Clear Form
2020-2021 Dependent
V4 Custom Verification Worksheet
Feather River College Financial Aid Office 570 Golden Eagle Avenue, Quincy CA 95971
Phone (530) 283-0202 ext 603 Fax (530) 283-4659 Email: financialaid@frc.edu
www.frc.edu/financialaid
DV4W21
Page2
(Print Student’s Name)
DO NOT COMPLETE THIS FORM IN ADVANCE
(MUST BE COMPLETED IN THE PRESENCE OF A FINANCIAL AID ADMINISTRATOR IN FRC FINANCIAL AID OFFICE OR A NOTARY PUBLIC)
B. Identity and Statement of Educational Purpose (To be signed at the institution)
The student must appear in person at Feather River College to verify his or her identity by presenting an unexpired
valid government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued
ID, or passport. The institution will maintain a copy of the student’s photo ID that is annotated by the institution
with the date it was received and reviewed, and the name of the official at the institution authorized to receive and
review the students ID. In addition, the student must sign, in the presence of the institutional official, the Statement
of Educational Purpose provided below.
C. Identity and Statement of Educational Purpose (To be signed in the presence of a notary)
If the student is unable to appear in person at Feather River College to verify his or her identity, the student must
provide to the institution:
(a) A copy of the unexpired valid government-issued photo identification (ID) that is acknowledged in the
notary statement below, or that is presented to a notary, such as, but not limited to, a driver’s license, other
state-issued ID, or passport; and
(b) The original Statement of Educational Purpose provided below, which must be notarized. If the notary
statement appears on a separate page than the Statement of Educational Purpose, there must be a clear
indication that the Statement of Educational Purpose was the document notarized.
D. Statement of Educational Purpose
I certify that I ________________________________________ 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 Feather River College for 2020-2021.
________________________________________________________________ ___________________
(Student’s Signature) (Date)
_________________________
(Student’s ID Number)
E. Notary’s Certificate of Acknowledgement
State of _______________________________________ City/County of ___________________________________
On_____________________, before me, _____________________________________________, personally appeared,
(Date) (Notary’s name)
____________________________________________________, and provided to me on the basis of satisfactory
(Printed name of signer)
evidence of identification ______________________________________________ to be the above-named person who
(Type of unexpired government-issued photo ID provided)
signed the foregoing instrument.
WITNESS my hand and official seal
(Seal) _________________________________________________
(Notary Signature)
My commission expires on ______________________
A. Student Information
Student’s Name: ________________________________________________ FRC ID: ______________________
2020-2021 Dependent
V4 Custom Verification Worksheet
Feather River College Financial Aid Office 570 Golden Eagle Avenue, Quincy CA 95971
Phone (530) 283-0202 ext 603 Fax (530) 283-4659 Email: financialaid@frc.edu
www.frc.edu/financialaid
DV4W21
Page3
F. High School Completion Status
High School Graduate/Equivalency Check the box of the document you will attach to this worksheet:
The original high school diploma or official high school transcript which includes the graduation date
The student’s original General Education Development (GED) certificate, an official GED transcript that indicates the student
passed the exam, or an original state-authorized high school equivalent certificate.
Students who completed secondary education in a foreign country, a copy of the “secondary school leaving certificate” or
other similar document*
Official academic transcript of a completed two-year program acceptable for full credit toward a bachelor’s degree
For a student who 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.
Non High School Graduate:
I do not meet any of the statements above.
Students who do not have a high school diploma or its equivalent and are beyond the age of compulsory education (18 in
California) are not eligible to receive financial aid unless they meet certain eligibility criteria regarding prior college
enrollment and may be considered under former Ability-to-Benefit (ATB) regulations. The Financial Aid Office will
determine if you meet these requirements.
Did you attend college classes prior to July 1, 2013? YES NO
College Name*: _____________________________________________ Major/Program of Study: ___________________
*If you did not attend FRC, you must attach official college transcript(s).
Did you officially register for college prior to July 1, 2013? YES NO
College Name: ______________________________________________ Major/Program of Study: ___________________
Are you currently enrolled in an eligible career pathway?
YES
NO
G. Certification and Signatures Each person signing this worksheet certifies that all of the information reported on it is complete
and correct. The student and one parent whose information was reported on the FAFSA must sign and date. Warning! If you
purposely give false or misleading information you may be fined, sentenced to jail, or both.
This worksheet must be signed and dated to be valid. Electronic and/or digital signatures are not valid.
Student Signature: _____________________________________________________ Date__________________
Parent Signature: _____________________________________________________ Date__________________
For Office Use Only
Identity and Statement of Educational Purpose:
Copy of original unexpired valid government-issued photo identification (ID) presented to institutional official
(financial aid staff)
Identification Type:
Institutional Official Name:
Institutional Official Signature: Date:
High School Completion Status:
Acceptable documentation in file
Type of documentation:
Approved
Denied
Comment(s):
Processed/Reviewed By:
Date:
2020-2021 Dependent
V4 Custom Verification Worksheet
Feather River College Financial Aid Office 570 Golden Eagle Avenue, Quincy CA 95971
Phone (530) 283-0202 ext 603 Fax (530) 283-4659 Email: financialaid@frc.edu
www.frc.edu/financialaid
DV4W21
Page4
How to use the IRS Data Retrieval Tool in FAFSA
o Go to www.studentaid.gov
o Login to using the students' FSA ID (https://fsaid.ed.gov/npas/index.htm)
o From the Dashboard, select ‘Apply for Aid’, click ‘Go to the FAFSA Form’, click ‘Log In’, select ‘I am the student’ or ‘I am a parent, preparer, or
student from a Freely Associated State, login with FSA ID and password, click ‘Next’, click to ‘Accept’ the disclaimer
o Select Make FAFSA Corrections and then create a temporary Save Key, click ‘Next’, click ‘Ok’
o Navigate to the Financial Information section of the application
o Follow the on-screen instructions. Based on your answers FAFSA will determine if the student or parent(s) can use the IRS Data Retrieval Tool
to transfer 2018 IRS income tax information into the FAFSA. If eligible to use the tool you will see a button that says Link to IRS
o Click the Link to IRS button which will redirect you to the Internal Revenue Service web site. A message will display explaining you are
‘leaving FAFSA on the web’. To continue with transferring your information, click Proceed to IRS site. Notice: for parent’s, you must enter the
parent’s FSA ID before clicking the Link to IRS button.
o Enter your address (must match your 2018 Federal Income Tax Return), city, state and zip code. Click Submit in the bottom right corner of the page.
o To transfer the data, click the box to place a checkmark under Transfer My Tax Information into the FAFSA section and then click the
Transfer Now button.
o Once you’ve transferred the data into FAFSA you will see Transferred from the IRS next to each question where the information was
transferred.
Notice: do not click ‘save’ and exit the application as you still need to finish the rest of the application. At the end of the application you need
to make sure you, and your parent (if applicable), sign your FAFSA using your FSA ID.
How to request your 2018 Tax Return Transcript or Verification of Non-filing Letter from the IRS
From the IRS website, you can request a tax return transcript through their Get Transcript Online or Get Transcript by Mail options by clicking on
the ‘Get Your Tax Record’. You can also contact the IRS by phone to request your tax return transcript. Note: the method you used to file your
return and whether you have a refund or balance due, affects your
current year transcript availability.
Get Transcript Online
Get Transcript by Mail
Get Transcript by Phone
To register and use this service, you need:
Full Name;
Access to your email account;
Date of birth;
Your Social Security Number or Individual Tax
Identification Number (ITIN);
Tax Filing Status and mailing address from latest
tax return;
Current address;
Personal account number from a credit card,
mortgage, home equity loan, home equity line
of credit or car loan and,
Mobile phone with your name on the account.
Note: if account setup is successful you will be able
to download and/or print your tax return transcript.
To use this service you need:
Your Social Security Number or Individual
Tax Identification Number (ITIN);
Date of birth and,
Mailing address from your latest tax
return
Note: transcripts generally arrive in 5-10
calendar days to the address the IRS has on file
for you. The IRS will never send an email
requesting that you obtain or access your
transcripts. If you receive such a notice, please
forward to the IRS fraud group at
phishing@irs.gov.
Call (800) 908-9946 and follow the
telephone prompts.
Notice: Be sure to request an IRS Tax Return Transcriptnot an IRS Tax Account Transcript. 2018 IRS Verification of Non-Filing
Letters must be dated on or after October 1, 2018.
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