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Low/No Income Verification – Independent (INLIV)
STUDENT NAME: ____________________________________________________________ WCC ID: ______________________________
ADDRESS: ___________________________________________ ________________________________________ ____________ _______________
STREET OR PO BOX CITY STATE ZIP
The income reported on your 2020-2021 FAFSA seems too low to meet basic living expenses. While this may be due to the valid
exclusion of certain types of income from the FAFSA, federal law states that we have the right to confirm the information that was
submitted before offering and/or disbursing federal student aid. This worksheet may be requested in addition to other verification forms
required by the U.S. Department of Education. PLEASE NOTE – Your eligibility for financial aid cannot be determined until the
verification process is complete.
INSTRUCTIONS: Complete this worksheet using blue or black ink, attach any required documentation, sign, and submit the completed
package to the WCC Financial Aid Office. IMPORTANT: If you were married on the day you signed and submitted your FAFSA,
you are required to include information for your spouse.
The Financial Aid Office will compare the information reported on the FAFSA for you and your spouse (if married) with the information
provided on this worksheet and any other required documentation. If there are any discrepancies between the information reported on
your FAFSA and the documents submitted to our office, your signature on this form authorizes our office to make the appropriate
corrections to your FAFSA.
Provide information about YEARLY income received for the period of January 1, 2018 through December 31, 2018. You
must enter a response for EACH question below. If an item does not apply to you, please enter -0- or N/A.
All 2018 Form W-2’s, 1099’s or other
statements of income earned
Pension or Retirement Funds
Social Security (disability or SSI)
2018 SSA-1099 (Social Security office)
Final payment stub from 2018
Veteran’s Non-Educational Benefits
Child Support (received for all
Proof of Child Support received
January – December 2018
Alimony or Spousal Support
Other (gifts, financial aid refunds, lottery
or gambling winnings, etc.)
Total Income from all sources
Review the federal assistance programs below and enter a check mark for all that were received by any member of your
household during 2018 or 2019. *Answering these questions will NOT reduce your eligibility for student aid or these programs.
Housing Assistance (Section 8,
Food & Nutrition Services (food
stamps, SNAP, EBT, etc.)
Supplemental Security Income
I/We did not receive any government assistance in 2018
Were you OR your spouse (if married) confined to jail/prison at any time during 2018?
If yes, the period of incarceration was: ______________ to _____________. Attach proof of incarceration (may vary by location)