Fillable 2020-2021 Verification Worksheet - Independent (Wenatchee Valley College)

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2020-2021 Verification Worksheet - Independent (Wenatchee Valley College)

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Verification Worksheet
Federal Student Aid Programs
Your application is selected for a review called “Verification.” In this process, WVC will be comparing information from your application
with your (and your spouse’s, if applicable) 2018 Federal tax information, W-2 forms or other financial documents. Federal regulations
give our office the right to request this information before awarding financial aid. If there are differences between your application
information and your financial documents, WVC will make corrections electronically to have your information reprocessed. To avoid
delays in processing your financial aid, please return verification items as soon as possible.
Wenatchee Valley College must review the requested information, under the financial aid program rules (CFR Title 34, Part 668).
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
A. STUDENT INFORMATION
_______________________________________ _____________________ ___ *SID FIELD (BELOW) IS REQUIRED*
Last Name
First Name
MI
__________________________________________
_____/______/______
__________________________
Address (include apt # if applicable)
Date of Birth
___________________________
_____
_________
( _____ ) _______ _________
City
State
ZIP Code
Daytime Phone (include area code)
Use this checklist to ensure you complete all steps – INCOMPLETE FORMS WILL NOT BE PROCESSED:
Complete this worksheet. ALL SECTIONS MUST BE COMPLETED. Enter a zero for amount if a field does not pertain to you.
Read instructions carefully and follow all directions. If you have questions, contact our office for assistance.
SIGN THE WORKSHEET **Digital/Electronic signatures accepted, and have same legal effect as a written signature)**
Attach all required documentation. Forms missing required documentation will be considered incomplete.
Submit worksheet, plus any required documentation, to the financial aid office at Wenatchee Valley College.
Please note that we may request other documents to verify additional information as we deem necessary.
B. FAMILY INFORMATION
List current household members as directed below. If any household member will be attending college at least half time,
enrolled in a degree or certificate program, include the name of the college. If you need more space, attach a separate page.
**If you have any questions about who to include in your household, contact the financial aid office.**
Include:
Yourself (list yourself first)
Your spouse (if married, and not separated)
Your children (under age 24), if you will provide more than half
of their support from July 1, 2020 through June 30, 2021.
Include other people as part of your household ONLY IF:
They are currently living with you,
and you provide more than half of their support
and you will continue to provide more than half of their support
from July 1, 2020 through June 30, 2021.
Documentation of support may be required
Full Name
Age
Relationship
College
(example) Martha Jones
24
Wife
1BCity University
STUDENT
Wenatchee Valley College
For
V1 V4 V5 0B 5# 5$
Page 1 of 4
Office
TR/EFC ______/_________
OK or
COMPLETE ALL FOUR PAGES
Incomplete forms will not be processed
Use
Corrected to ______/___________
Only:
Initials: _______
Date: __________
2020-2021
INDEPENDENT
07
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2020-2021
SID: ______ _____ _________
INDEPENDENT
Verification Worksheet
Federal Student Aid Programs
First:
Last:
__________________________________
__________________________________
C. INCOME INFORMATION page 2 of 4
Read carefully and follow the instructions in each section. If you have questions or problems, contact us for help.
Tax-filers: You will need to use one of the following three options to verify income:
A. IRS Data Retrieval Tool (DRT) within FAFSA: Go to FAFSA.gov, log in, select “Make FAFSA Corrections,” and navigate to
the Financial Information section. Follow instructions. Make sure you save, sign and submit the FAFSA when complete.
B. Official Tax Return Transcript: You can request a FREE 2018 tax return transcript online at www.irs.gov or download the
4506-T from www.wvc.edu/financialaid/forms. (note: when you receive it, keep original, submit a copy to us)
C. SIGNED Copy of Filed Tax Return: Include copies of ALL schedules submitted with filed return.
NON tax-filers: Attach copies of all W2s. Also attach an official IRS “Verification of Non-filing Letter”. You can download this
from www.irs.gov/individuals/get-transcript. If you are unable to do this, contact our office for help with alternative
documentation.
1. MARITAL STATUS:
As of today, I am: (check the correct boxes below and follow the instructions)
Married and living with my spouse (Instructions: Complete Items #2 and #3 below)
Single, divorced, widowed, or separated from spouse AND
I did NOT file a joint tax return for 2018 (Instructions: Complete #2, Skip #3 below.)
I filed a Joint tax return for 2018 (Instructions: Contact our office for assistance in completing this form.)
2. STUDENT EARNED INCOME & TAX INFORMATION:
Check only ONE box and follow directions – if you have questions, contact the financial aid office
I am attaching a SIGNED copy of my 2018 IRS tax return or official IRS transcript.
I used the IRS Data Retrieval Tool (see instructions at top of page) to transfer my 2018 tax information to my
FAFSA & MADE NO CHANGES TO THE DATA RETRIEVED. Date this was done: _______________
I filed an AMENDED tax return after my initial 2018 tax return. Attach BOTH a signed copy of IRS tax form 1040X
AND
either
a Tax Return Transcript or a SIGNED copy of IRS tax return showing initial return information.
NON-FILER: I (Student) will not file - and am not required to file - a 2018 tax return. *MUST ATTACH OFFICIAL
IRS “VERIFICATION OF NON-FILING LETTER” and complete the remainder of this section.*
**CHECK ONE BOX**: I (student) was employed & had
earned income from work in 2018 Yes* No
*If “YES”, list all employer(s) & income received in 2018
and attach copies of all W-2s. (attach add’l sheet if needed)
List all Employer[s]
Total Income Earned
$
$
3. SPOUSE EARNED INCOME & TAX INFORMATION: (Complete this section only if currently married & living with spouse)
Check ONE box and follow any instructions – if you have questions, contact the financial aid office
My spouse and I filed a joint 2018 federal income tax return.
My spouse filed a separate 2018 tax return. Attach SIGNED copy of Spouse’s 2018 return or official IRS transcript.
My spouse filed separately & later AMENDED the 2018 tax return. Attach BOTH a signed copy of IRS tax form 1040X
AND
either
a Tax Return Transcript or a SIGNED copy of IRS tax return showing initial return information
NON-FILER: My spouse will not file - and is not required to file - a 2018 tax return. *MUST ATTACH OFFICIAL IRS
“VERIFICATION OF NON-FILING LETTER” and complete the remainder of this section.*
**CHECK ONE BOX**: Spouse was employed & had
earned income from work in 2018 Yes* No
*If “YES”, list all employer(s) & income received in 2018
and attach copies of all W-2s. (attach add’l sheet if needed)
List all Employer[s]
Total Income Earned
$
$
Page 2 of 4
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2020-2021
SID:______ ______ ________
INDEPENDENT
Verification Worksheet
Federal Student Aid Programs
Last: _____________________________________
First: _____________________________________
D. UNTAXED INCOME & UNTAXED BENEFITS/ASSISTANCE page 3 of 4
Answer #1 and #2, following the instructions for each. If you have questions, please contact our office for assistance.
1. STUDENT UNTAXED BENEFITS/ASSISTANCE:
Instructions: If you and/or any of the household members listed on page 1 received any of these items during any of the time
periods, check the appropriate boxes. **Do NOT enter dollar amounts. These benefits do NOT get counted as income, and
receiving them does NOT hurt your eligibility for financial aid ** If none of the items apply to your household, check box “ l”.
Benefit Type A-E
2017-2018
2019 -
Current
Benefit Type F-J
2017-2018
2019 -
Current
a. Food Stamps/SNAP
f. Untaxed Social Security
b. Welfare/TANF
g. Subsidized Housing
c. Supplemental Security Inc. (SSI)
h. Child Care Assistance
d. Free or Reduced Lunch
i. Medical Assistance (e.g., Medicaid/Apple Health)
e. WIC
j. Utility Assistance
k. If student and/or spouse attended college in any of the years listed below and received financial aid that helped pay your
living expenses, complete the following (note: does not affect your eligibility for financial aid):
Student: 2018 2019 2020 College Name[s] ________________________________________________
Spouse: 2018 2019 2020 College Name[s] ________________________________________________
l . None of the above (items a- k) applies to myself or my household members.
2. STUDENT UNTAXED INCOME:
Instructions: Answer each of the following about YOURSELF (and spouse if married). If they do not apply to you, enter zeros. Do
not include benefit types listed in question 1. (Enter amount for the year 2018, rounded to the nearest dollar)
Yearly
Amount
Source of Untaxed Income
$
a. Child support received in 2018
$
b. Worker’s Compensation
45i
$
c. Payments to tax-deferred pension & savings list source: ___________________________ (see help below)
*help for c (above): List payments (direct or withheld from earnings) to tax-deferred pension & retirement savings
plans (e.g., 401(k) or 403(b) plans), incl., but not limited to, amounts reported on W-2 forms in Boxes 12a - 12d with
codes D, E, F, G, H, & S. Don’t include amounts reported in code DD.
$
d. Living allowance paid to clergy or military (military: include only BAS, do not include BAH)
$
e. Veterans non-education benefits (incl: Disability, Death Pension, DIC, VA Work-Study allowances)
$
f. Any other untaxed income NOT included on tax return list source: _____________________________
$
g. List any money received or paid on the student’s behalf (e.g., payment of student’s bills) that is not
reported elsewhere on this form. (see help below) Also, list the sources & the purpose of the payments:
___________________________________________________________________________________
*help for g (above): Enter the total amount of cash support the student (&/or spouse) received in 2018. For example, if
someone is paying rent, utility bills, etc., for the student or gives cash, gift cards, etc., include the amount of that person's
contributions. Also, include any distributions to the student from a 529 plan owned by someone other than the student, such
as parents, grandparents, aunts, & uncles of the student.
Staff Use Only: ___ 44a=2c above ___ 44c=2a above ___44f=2d above ___44g=2e above
___ 44b= 1040-Schedule 1, Lines 28+32
___ 44d= 1040- Line 2a
___ 44e= 1040-Lines 4a minus 4b (excl. rollovers)
___ 44h= 1040-Schedule 1, Line 25, *plus “3b” and “3f” above*
___44i= all other (stu/spouse owned 529s go under #42 (investments)
___
Page 3 of 4
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T:\Forms\2021\Verif-Indep\Verification Worksheet-2021-Independent-pg4.docx
2020-2021
INDEPENDENT
Verification Worksheet
Federal Student Aid Programs
SID: _______ ______ __________
Last: _________________________________________
First: _________________________________________
E. ADDITIONAL FINANCIAL INFORMATION - INCOME EXCLUSIONS page 4 of 4
Answer each item in this section. Do not leave any item blank. If you have questions, please contact our office for assistance.
1. STUDENT INCOME EXCLUSIONS:
The 2020-2021 FAFSA refers to “Additional Financial Information” for 2018. The financial aid office must verify the
dollar amounts from the 2018 calendar year. Please answer each of the following. If they do not apply to you (and/or
spouse if married), enter zeros, or check “NO”.
Yearly
Amount
Exclusion Type (if you have questions about any of these items, please contact our office)
$
Taxable earnings from Federal or State Work-study. (Attach W-2 of work-study earnings from college)
If any college employed you as a work-study student, you would have received a W-2 for your 2018 earnings
$
Combat Pay or Special combat pay. List ONLY the taxable portion reported in the AGI on your 2018 tax return.
$
Rollovers (of IRA & other pensions). List ONLY the taxable portion reported in the AGI on your 2018 tax return.
No Yes*
Child Support PAID to others in 2018. Do NOT include support you received. *If YES, complete worksheet below
Who paid Child Support
Name of Person to whom
Child Support was paid:
Name of Child for whom
support was paid
Age of
child
Amount of Child
Support Paid in 2018
Student Spouse
$
Student Spouse
$
Student Spouse
$
Total
$
Sign This Worksheet
By signing this worksheet, I (we) certify that all the information
reported on this worksheet is complete and correct.
Return this completed form (with required documents) to:
Wenatchee Valley College
Phone 509-682-6810
Financial Aid Office
Fax 509-682-6811
1300 5
th
Street – Wenatchi Hall
Email: financialaid@wvc.edu
Wenatchee WA 98801
http://www.wvc.edu
_________________________________
__________
Student
Date
_________________________________
__________
Spouse (optional, not required)
Date
Tips to avoid delays in processing:
Before submitting, review the entire form. Make sure that:
You completed all four pages
There are no unanswered questions
All questions are answered accurately
You have signed and dated this page
You have attached all required SIGNED tax returns or IRS transcripts, W2’s, etc.
If you used the IRS Data Retrieval Tool to transfer tax data, check your updated
FAFSA Student Aid Report to verify the transfer and submission went through.
Our office uploads new transactions weekly. You can view and check your new
transaction online at FAFSA.gov as soon as it is processed.
Page 4 of 4
WARNING: If you purposely give false or misleading information on this
worksheet, you may be fined, sentenced to jail, or both.
**If electronically signed, I/we understand that a digital or electronic typed signature has the
same legal effect and can be enforced in the same way as a written signature. **
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This page is for information purposes only. It is not required to be submitted with your form.
_____________________________________________________
Wenatchee Valley College
Non-discrimination Statement
Wenatchee Valley College is committed to a policy of equal opportunity in employment and student enrollment. All programs are free
from discrimination and harassment against any person because of race, creed, color, national or ethnic origin, sex, sexual orientation,
gender identity or expression, the presence of any sensory, mental, or physical disability, or the use of a service animal by a person
with a disability, age, parental status or families with children, marital status, religion, genetic information, honorably discharged
veteran or military status or any other prohibited basis per RCW 49.60.030, 040 and other federal and laws and regulations, or
participation in the complaint process.
The following persons have been designated to handle inquiries regarding the non-discrimination policies and Title IX compliance for
both the Wenatchee and Omak campuses:
• To report discrimination or harassment: Title IX Coordinator, Wenatchi Hall 2322M, (509) 682-6445, title9@wvc.edu.
• To request disability accommodations: Student Access Coordinator, Wenatchi Hall 2133, (509) 682-6854, TTY/TTD: dial
711, sas@wvc.edu.
Wenatchee Valley College
Declaraciones de no discriminación
Wenatchee Valley College está comprometido a una política de igualdad de oportunidades en el empleo y la matriculación de
estudiantes. Todos los programas están libres de discriminación y acoso contra cualquier persona debido a raza, credo, color, origen
nacional o étnico, sexo, orientación sexual, identidad o expresión de género, la presencia de cualquier discapacidad sensorial, mental o
física, o el uso de un animal de servicio por una persona con discapacidad, edad, estatus o familias con niños, estado civil, religión,
información genética, veterano descargado honorablemente o estatus militar o cualquier otra base prohibida por el RCW 49.60.030,
040 y otras leyes y reglamentos federales, o participación en el proceso de queja.
Las siguientes personas han sido designadas para atender consultas sobre las políticas de no discriminación y el cumplimiento del
Título IX para los campus de Wenatchee y Omak:
• Para denunciar discriminación o acoso: Coordinador del Título IX, Wenatchi Hall 2322M, (509) 682-6445, title9@wvc.edu.
• Para solicitar adaptaciones para discapacitados: Coordinador de acceso estudiantil, Wenatchi Hall 2133, (509) 682-6854,
TTY/TTD: marque 711, sas@wvc.edu
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2020-2021 Verification Worksheet - Independent (Wenatchee Valley College)

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