2020-2021
VERIFICATION OF DEPENDENTS
Central Alabama Community College
DEPEND
Student’s Name: __________________________ Student Number: _________________________
Address: __________________________________ Phone Number: ___________ Date of Birth: _________
On your Free Application for Federal Student Aid (FAFSA) you indicated that you now have or will have
children and/or legal dependents who will receive more than half of their support from you between July 1,
2020 and June 30, 2021.
Please ‘X’ the box that indicates your dependent(s) status.
_______I do not now have or will have children or legal dependent who receive more than half of their support
from me between July 1, 2020 and June 30, 2021.
_______I now have or will have children who will receive more than half of their support from me between
July 1, 2020 and June 30, 2021?
*****If X’, please list the name(s) of your dependents and the relationship to you, the student.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
*****If ‘X’, please specify the source(s) of income in which you will be using to cover housing, food, utilities,
transportation, and living allowances for you and your dependent(s) from July 1, 2020 until June 30, 2021.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_______I now have or will have legal dependents who will receive more than half of their support from me
between July 1, 2020 and June 30, 2021?
*****If ‘X’, please list the name(s) of your dependents and the relationship to you, the student.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
*****If ‘X’, please specify the source(s) of income in which you will be using to cover housing, food, utilities,
transportation, and living allowances for you and your dependent(s) from July 1, 2020 until June 30, 2021.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
I confirm that the statement above and information provided is true
and accurate to the best of my knowledge as of this date.
_________________________________________ _________________________________________
Student Signature Date
Please return the completed form to:
Central Alabama Community College Financial Aid Office
Alexander City Campus: 1675 Cherokee Road, Alexander City, AL 35010 OR Childersburg Campus: 34091 US Highway 280, Childersburg, AL 35044
WARNING: If you purposely give false
or misleading information, you may
be fined, sent to prison, or both.
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