2020-2021 Verification Worksheets
For Independent Student
Student’s Last Name, First, MI Student’s Social Security Number
Student’s Street Address (include apt. no.) City, State, Zip Code
Student’s Primary Phone Number Student’s Email Address
Independent Student’s Family Information
Starting with yourself: List each person, starting with yourself, living in your household if they’re receiving more than
half of their support from you, (include spouse, children, etc…) their relationship to you, and whether or not they will
be attending college in the 2020-2021 school year.
If more space is needed, provide a separate page with the student’s name and ID number at the top.
Full Name
Name of College
Attending in
Will be Enrolled at
Least Half Time
(Yes or No)
Note: We may require additional documentation if we have reason to believe that the information regarding the household members
enrolled in eligible postsecondary educational institutions inaccurate.
Student’s Signature Date
Your 2020-2021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says
that before awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify that you
provided correct information, we will compare your FAFSA with the information on this institutional verification document and with any
other required documents. If there are differences, your FAFSA information may need to be corrected. You whose information was
reported on the FAFSA must complete and sign this institutional verification document, attach any required documents, and submit the
form and other required documents to us. We may ask for additional information. If you have questions about verification; contact us
as soon as possible so that your financial aid will not be delayed.
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Student’s Name_______________________________ Student’s Social Security Number___________________
Verification of 2018 IRS Income Information for Tax Filers
Student’s Income:
Important Note: If the student and/or parent(s) filed, or will file an amended 2018 IRS tax return, the
student must contact the financial aid administrator before completing this section.
IF THE STUDENT FILED A TAX RETURN WITH THE IRS FOR 2018 (Check the box that applies)
The student has used the IRS DRT in FAFSA on the Web to transfer 2018 IRS income tax return information into
student’s FAFSA
The Student is unable or chooses not to use the IRS DRT in FAFSA on the Web, and instead will provide the
school an official 2018 IRS Tax Return Transcript (s) directly from the IRS (Unofficial or CPA copies of the
2018 Transcripts WILL NOT be accepted)
IF THE STUDENT IS A NON-TAX FILER: (check the box that applies)
The student was not employed and had no income earned for work in 2018
The student was employed in 2018 and earned income; but DID NOT file taxes.
In the grid below, please list each employer from 2018, the amount earned, and whether or not a W2 was provided.
If more space is needed, provide a separate page with the students name and ID number at the top.
Employer’s Name
2018 Amount Earned
Suzy’s Auto Body Shop (example)
Certifications and Signatures
Each person signing below certifies that all the information reported is complete and correct. The student and
parent whose information was reported on the FAFSA must sign and date.
Print Students Name
Student’s Signature Date
Frank Phillips College is an equal opportunity education institution and employer. Its students and employees are
selected and/or assigned without regard to age, race, color, creed, sex, national origin, or disability, consistent with
Titles VI and VII of the Civil Rights Act of 1964, and Title IX of the Higher Education Act amended in 1972, and Section
504 of the Rehabilitation Act of 1973. The compliance coordinator for Title IX is Dr. Shannon Carroll
(scarroll@fpctx.edu; 806-457-4200, ext. 732) and Section 504 is Becky Green (bgreen@fpctx.edu; 806-457-4200, ext.
IF you purposely give false or misleading information you may be fined, be sentenced to jail, or both.
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