2020-21 Household Size / Number in College Verification Worksheet Dependent
Your FAFSA application was selected by the U.S. Dept. of Education for review in a process called “verification.” In this
process we are required by federal law (34 CFR, Part 668) to compare the information from your FAFSA application with
the information provided on this form. If there are differences between your application information and your verification
documents, we may need to correct your FAFSA information. We cannot process your financial aid until verification has
been completed. Please provide the required documents as soon as possible.
A. Student Information (please print clearly)
Last Name First Name M.I. Student ID Number or Star ID
Email Address Phone Number (include area code)
Address
City State Zip Code
B. Family Information
List the people that your parents will support between July 1, 2020 and June 30, 2021. List the name of the college each attends, if
applicable.
Include:
1. Yourself (even if you do not live with your parents)
2. Your parent(s) – including any stepparent that you listed on your FAFSA form, and unmarried parents who are living together.
3. Your parent’s other children (if your parent provides more than half of their support or if they would be required to give parental
information when filling out a FAFSA)
4. Other people for whom your parent provides more than half of their support and will continue that support from July 1, 2020
through June 30, 2021.
Full Name Age Relationship to Student College Currently Attending
more credits?
C. Signatures
WARNING: If you purposely give false or misleading information, you may be fined, sentenced to prison, or
both.
We certify that all of the information reported on this worksheet is complete and correct. The student and parent must sign
this worksheet.
_______________________________________________ _____________________________________________
Student Signature Date Parent Signature Date
3300 Century Avenue North
White Bear Lake, MN 55110
Phone: 651-779-3305
Fax: 651-779-5816
E-mail: finaid@century.edu
A MEMBER OF THE MINNESOTA STATE COLLEGES & UNIVERSITY SYSTEM
AN AFFIRMATIVE ACTION EQUAL OPPORTUNITY EMPLOYER & EDUCATOR
click to sign
signature
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click to sign
signature
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