23DVW myUH ID________________
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434 University Drive, Houston, Texas 77204-2010 · Phone (713)743-1010 · Fax (713)743-9098
Welcome Center hours: Monday-Thursday, 8 a.m.-5 p.m.; Friday, 9 a.m.-5 p.m. · www.uh.edu/verification
2022-2023 VERIFICATION WORKSHEET – DEPENDENT
Your application was selected for review process called “Verification.” In this process, UH will be comparing information from your
FAFSA with copies of your financial documents.
The law says we have the right to ask you for this information before awarding Federal aid. If
there are differences between your application information and your financial documents, you or your school may need to make corrections
electronically or by using your Student Aid Report (SAR).
This form should ONLY be submitted if our FAFSA
application was selected for the verification process.
Instructions:
1. Complete, sign and date the worksheet. Please make sure no fields are left blank.
2. Submit this form and any other documents initiated in your myUH To-Do List to:
The Office of Scholarships and Financial Aid
In Person: Welcome Center
Online: Via your myUH self-service account To-Do List
Visit uh.edu/sfaupload for more information on how to upload your verification forms online.
A. Student Information
L
ast Name First Name
MI
myUH ID
E
mail Address
B. Family Information
List the number of people in your parents’ household, including:
•
Yourself
•
Your parent(s) (stepparent, if remarried or biological parents, if living together)
•
Children and/or Dependents for whom your parent(s) will provide more than 50% of their support from July 1, 2022 - June 30, 2023.
You MUST PROVIDE the names and ages of all household members listed in the space(s) below.
Also, write in the name of the college for any household member, excluding your parent(s), who will be attending at least half-time
between July 1, 2022 and June 30, 2023, and will be enrolled in a degree, diploma or certificate program.
If you need more space attach a separate page.
College Enrolled in at Least Half
FAFSA Parent 2/Stepparent
C. Print and Sign this Worksheet (NO digital or electronic signatures – failure to print and sign will delay your financial aid)
Each person signing this form certifies that all the information reported on it is complete and correct. The student, and at least one
parent whose information was reported on the FAFSA must sign and date. WARNING: If you purposely give false or misleading
information on this worksheet, you may be fined, be sentenced to jail, or both.
Student Signature
Date
Parent Signature
Date
State law requires that you be informed of the following: (1) with few exceptions, you are entitled on request to be informed about the information the University collects about you by use of this form; (2) under sections 552.021 and
552.023 of the Government Code, you are entitled to receive and review the information; and (3) under section 559.004 of the Government Code, you are entitled to have the University correct information about you that is incorrect.
To-Do List Legend
Received
In our records, but not reviewed
ncomplete
Reviewed, but more info needed
