20202021 Verification Worksheet
Dependent Student
Your 20202021 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 the financial aid administrator at
your school 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 must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the financial aid
administrator at your school. Your school may ask for additional information. If you have questions about verification, contact your financial aid administrator as soon as
possible so that your financial aid will not be delayed.
A. Dependent Student’s Information
Student ID #__________________________ Student’s Social Security Number ____________________________________
_________________________________________________________________ .
Student’s Last Name Student’s First Name M.I. Student’s Home Phone
_____________________________________________________________ .
Student’s Street Address City/State/Zip Student’s Alternate or Cell Phone Number
B. Dependent Student’s/Parents Family Information
List below the people in your Parent’s household: INCLUDE ONLY PEOPLE THAT PARENT’S WILL SUPPORT MORE THAN 50%
Parent’s household includes: student (even if student does not live with parent) and parents (including a stepparent).
The parent’s other children if the parents will provide more than half of their support from July 1, 2020, through June 30, 2021 or
if the other children would be required to provide parental information when completing the FAFSA for 2020-2021. Include
children who meet either of these standards even if the children do not live with the parents.
Other people if they now live with the parents and the parents provide more than half of their support and
will continue to provide more than half of their support from July 1, 2020, through June 30, 2021.
Full Name
Age
Relationship
Name of College if
enrolled between
7/1/20 and 6/30/21
Enrolled in a degree program at
Least Half Time -Yes or No
Self
C. Dependent Student’s/Parents Income Information to Be Verified
N
O
N
T
A
X
F
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SECTION FOR STUDENT NONTAX FILERS ONLY
Complete this section if you, the student, will not file and you are not
required to file a 2018 income tax return. Check the one that
applies:
____ The student was not employed and had no income earned from
work in 2018.
_____ The student was employed in 2018 and did not and WAS NOT
REQUIRED TO FILE TAXES and has listed below the names of
all employers, the amount earned from each employer in 2018, and
whether an IRS W-2 form is attached. Attach copies of all 2018 W-2
forms issued to you by employers. List every employer even if the
employer did not issue an IRS W-2 form. If more space is needed,
attach a separate page with your name and ID number at the top.
2018 Amount
Earned
IRS W-2
Attached
SECTION FOR PARENT NONTAX FILERS ONLY
Complete this section if you, the Parent(s) will not file and are not
required to file a 2018 income tax return with the IRS. Check the
one that applies:
____ Attached is the required signed statement from parent
regarding non-filing for 2018.
___ Attached is the Verification Letter of Non-Filing received
from the IRS
____ One or both parents were employed in 2018 but WERE NOT
REQUIRED TO FILE TAXES and have listed below the
names of all employers, the amount earned from each employer
in 2018, and whether an IRS W-2 form is provided. Attach
copies of all 2018 W-2 forms issued to you by employers. List
every employer even if the employer did not issue an IRS W-2
form. If more space is needed, attach a separate page with your
name and ID at the top.
Employer’s Name
2018 Amount
Earned
IRS W-2
Attached
Student’s Name: __________________________________________ Student ID#__________________________
D. STUDENT/ PARENTS WITH UNUSUAL CIRCUMSTANCES
____ Filed an Amended IRS Income Tax Return: If an individual filed an amended IRS income tax return for tax year
2018, the individual is required to provide a signed copy of IRS Form 1040X, along with an original signed copy of the 2018 1040,
1040A or 1040EZ and W-2s.
____ Victim of IRS Identity Theft: A victim of IRS identity theft who has been unable to obtain a 2018 IRS Tax Return
Transcript or use the IRS DRT must provide a signed copy of the 2018 paper IRS income tax return and W-2s that were filed
with the IRS and a signed copy of IRS Form 14039 “Identity Theft Affidavit” if one was submitted to the IRS. If the
individual did not keep a copy of Form 14039 or the IRS did not require him or her to submit one, he or she may
provide one of the following:
A statement signed and dated by the individual indicating that he or she was a victim of IRS identity theft and that the IRS is
investigating the matter. The statement must also indicate that the individual submitted a Form 14039 to the IRS but did not keep
a copy of it or that he or she was not required to file the form; or
A copy of a police report if it was filed related to the IRS identity theft.
____ Filed Non-IRS Income Tax Returns: If an individual filed or will file a 2018 income tax return with Puerto Rico, another U.S.
territory (e.g., Guam, American Samoa, the U.S. Virgin Islands, the Northern Mariana Islands), or with a foreign country,
the individual is required to provide a signed copy of that 2018 income tax return(s) and W-2s.
Each person signing this form certifies that all the information reported on it is complete and correct.
Student Signature Date
Parent’s Signature Date
T
A
X
F
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THIS SECTION IS FOR STUDENT TAX FILERS ONLY
Complete this section if you, the student, filed a 2018 IRS income tax
return(s). Check the one that applies:
_____ The student has provided a signed copy of the 2018 1040,
1040A or 1040EZ along with W-2s. If the student and
spouse filed separate 2018 IRS income tax returns,
signed copies with W-2’s must be provided for both.
____ The student used the IRS Data Retrieval Tool (DRT)
and provided a copy of W-2’s.
_____ The student has provided a 2018 IRS Tax Transcript(s)
and W-2’s.
THIS SECTION IS FOR PARENT TAX FILERS ONLY
Complete this section if the parents filed a 2018 IRS income tax
return(s). Check the one that applies:
_____ The Parent has provided a signed copy of the 2018 1040,
1040A or 1040EZ along with W-2s. If the parent and
spouse filed separate 2018 IRS income tax returns,
signed copies with W-2’s must be provided for both.
____ The parent(s) used the IRS Data Retrieval Tool (DRT)
and provided copies of W-2’s.
_____ The parent(s) have provided a 2018 IRS Tax Transcript(s)
and W-2’s.
Note: If the parents filed separately and are married or
unmarried and living together, IRS Tax Transcripts and
W-2s must be provided for both parents.
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