2021-2022
Verification of Student’s
Marital and/or Tax Filing Status
Louisiana College – Financial Aid Office – 1140 College Dr Box 582 Pineville, La. 71359
Phone (318) 487-7386 – Fax (318) 487-7449 – Email: financial_aid@lacollege.edu
https://lacollege.edu/campus-life/financial-aid/
F. Certification and Signatures – Each person signing this worksheet certifies that all of the information reported on it is complete
and correct. The student whose information was reported on the FAFSA must sign and date. Warning! If you purposely give false
or misleading information you may be fined, sentenced to jail, or both.
Student Signature: _____________________________________________________ Date: _________________
Spouse Signature: ______________________________________________________ Date: _________________
(optional)
This worksheet must be signed and dated to be valid. Electronic and/or digital signatures are not valid.
D. Head of Household Eligibility – To be completed by student
According to IRS Publication 17, an individual may be able to file as head of household if they meet all the following
requirements:
1. You are unmarried or “considered unmarried” on the last day of the year.
2. You paid more than half the cost of keeping up a home for the year.
3. A qualifying person lived with you in the home for more than half the year (except for temporary absences, such as
school).
If you are legally married and filed your taxes as Head of Household for 2019 you may need to file an amended tax return (form
1040X) reflecting the correct filing status. If your tax professional indicated that you were eligible to file as head of household
(despite being married); please continue to complete this form and, if available, provide a statement from your tax professional on
their company letterhead.
Initial next to each of the following requirements, only if the requirement is applicable to your tax filing circumstances.
Considered Unmarried Eligibility Requirements
_______ You filed a separate return.
_______ You paid more than half the cost of keeping up your home for the tax year.
_______ Your spouse did not live in your home during the last 6 months of the tax year. Your spouse is
considered to live in your home even if he or she is temporarily absent due to special circumstances.
_______ Your home was the main home of your child, stepchild, or foster child for more than half the year.
_______ You must be able to claim an exemption for the child. However, you meet this test if you cannot claim
the exemption only because the non-custodial parent can claim the child.
Head of Household Eligibility Requirements
_______ You were married but considered unmarried on December 31, 2019 (If you initialed all of the previous criteria initial here)
_______ You paid more than half the cost to keeping up your home for the tax year.
_______ A qualifying person lived with you in the home for more than half the year (except for temporary absences, such as
school). However, if the qualifying person is your dependent parent, he or she does not have to live with you.
E. Personal Statement – Explain in detail why you were allowed to use that filing status given your marital status and,
if available, please provide a letter of explanation from your tax preparer or the IRS.
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