Office of Financial Aid
323 Erie Street, P.O. Box 5015, Port Huron, Michigan 48061-5015
810-989-5530 fax 810-989-5774 sc4.edu
4/8/2020
2020-2021 Verification Worksheet Independent Student
Your 20202021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called
verification. The law states that before awarding Federal Student Aid, we may ask you to confirm the information you and
your parent(s) reported on your FAFSA. To verify that you provided correct information, the SC4 Financial Aid office will
compare your FAFSA with the information on this worksheet and with any other required documents. If there are
differences, your FAFSA information may need to be corrected. You and at least one parent must complete and sign this
worksheet, attach any required documents, and submit the form and other required documents to the Financial Aid Office.
The Financial Aid Office may ask for additional information. Failure to submit the required forms within 60 days may result
in your financial aid application being denied. If you have questions about verification, contact the Financial Aid Office as
soon as possible so that your financial aid will not be delayed.
A. Independent Student’s Information
Last Name _________________________ First Name_______________________________ MI________
Student’s Social Security __________________________Student Date of Birth_______________________
Street Address_______________________________________City_____________State_____ Zip_______
Student’s Phone _______________________________ Student’s Email____________________________
B. Independent Student’s family information
List below the people in your parent(s)’ household. Include:
Yourself.
Your spouse, if you are married
Your children, if any, if you will provide more than half of their support from July 1, 2020, through June 30, 2021,
or if the child would be required to provide your information if they were completing a FAFSA for 20202021.
Please include children who meet either of these standards, even if they do not live with you.
Other people if they now live with you and you provide more than half of their support and will continue to provide
more than half of their support through June 30, 2021.
Include the name of the college for any household member, excluding your parent(s), who will be enrolled, at least half
time in a degree, diploma, or certificate program at a postsecondary educational institution any time between July 1,
2020, and June 30, 2021. If more space is needed, attach a separate page with the student’s name and Social Security
Number at the top. Note: We may require additional documentation if we have reason to believe the information regarding
household members enrolled in an eligible postsecondary institution is inaccurate.
Full Name
Age
Relationship
College
Will be Enrolled at
least half time?
Missy Jones (example)
18
Sister
Central University
Yes
Self
Student ID:_______________
Rec’d by:_________________
Date:____________________
Office of Financial Aid
323 Erie Street, P.O. Box 5015, Port Huron, Michigan 48061-5015
810-989-5530 fax 810-989-5774 sc4.edu
4/8/2020
Student’s Name: ______________________________________________ SSN: __________________________
C. Independent Student’s Income Information to be verified
1. Tax Return Filers Important Note: If the student filed or will file an amended 2018 IRS tax return, the student
must contact the Financial Aid Office before completing this section.
Instructions: Complete this section if you, the student, filed or will file a 2018 income tax return with the IRS. The best
way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA on the Web. If you have not already
used the tool, go to FAFSA.gov, log in to your FAFSA record, select “Make FAFSA Corrections,” and navigate to the
Financial Information section of the form. From there, follow the instructions to determine if you are eligible to use the
IRS Data Retrieval Tool to transfer 2018 IRS income tax information into your FAFSA. It takes up to two weeks for IRS
income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and up to eight
weeks for paper IRS tax return filers. If you need more information about when, or how to use the IRS Data Retrieval
Tool see your financial aid administrator.
Check the box that applies:
I, the student has used the IRS Data Retrieval Tool in FAFSA on the Web to retrieve and transfer 2018 IRS income
information into the student’s FAFSA, either on the initial FAFSA or when making a correction to the FAFSA. SC4 will
use the IRS information that was transferred in the verification process.
I, the student has not yet used the IRS Data Retrieval Tool in FAFSA on the web but will use the tool to retrieve and
transfer 2018 IRS income information into the student’s FAFSA once the student has filed a 2018 IRS tax return. See
instructions above for information on how to use the IRS Data Retrieval Tool. SC4 cannot complete the verification
process until the IRS information has been transferred into the FAFSA.
I, the student is unable or chooses not to use the IRS Data Retrieval Tool in FAFSA on the Web, and the student
will submit to the school a 2018 IRS signed tax return.
Check here if the student’s IRS SIGNED tax return is attached to this worksheet.
Check here if IRS tax return(s) will be submitted to your school later. Verification cannot be completed until the
IRS tax return(s) have been submitted to SC4.
2. Tax Return Nonfilers Complete this section if you, the student (and, if married, your spouse), will not file and are not
required to file a 2018 income tax return with the IRS. A proof of non-filing letter from the IRS dated after October 1, 2019
must be provided that indicates a 2018 income tax return was not filed with the IRS or other relevant tax authority. To obtain
this letter visit www.irs.gov, call 1-800-908-9946, or complete IRS form 4506-T
Check the box that applies:
The student was not employed and had no income earned from work in 2018.
The student was employed in 2018 and has listed below the names of all the student’s employers, the amount
earned from each employer in 2018, and whether an IRS W-2 form is attached. Attach copies of all 2018 IRS W-2
forms issued to the student by employers. List every employer even if they did not issue an IRS W-2 form. If more
space is needed, attach a separate page with the student’s name and Social Security Number at the top.
Employer’s Name
2018 Amount Earned
Suzy’s Auto Body Shop (example)
$2,000(example)
Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2018 that indicates a 2018
IRS income tax return was not filed with the IRS or other relevant tax authority.
Check here if confirmation of nonfiling is provided.
Check here if confirmation of nonfiling will be provided later
Office of Financial Aid
323 Erie Street, P.O. Box 5015, Port Huron, Michigan 48061-5015
810-989-5530 fax 810-989-5774 sc4.edu
4/8/2020
Student’s Name: ______________________________________________ SSN: __________________________
D. Certification and Signature
I certify that all of the information reported on this worksheet is complete and correct. The student must sign this
worksheet. If married, the spouse’s signature is optional.
Student’s Signature _________________________________________________ Date _________________
Spouse’s Signature _________________________________________________ Date _________________
If you are able, please print and physically sign this form. If you do not have access to print, please type your name above, but you will
need to come into the Financial Aid office once we re-open to sign.
Warning: If you purposely give false or misleading information on this worksheet, you may be fined, be
sentenced to jail, or both.
Submit this worksheet to the Financial Aid Office at SC4.
St. Clair County Community College
financialaid@sc4.edu
You should make a copy of this worksheet for your records.
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