Fillable A)I RSITY ARKANSAS 20212022 Verification Worksheet = IIDUlff

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A)I RSITY ARKANSAS 20212022 Verification Worksheet = IIDUlff

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OFFICE OF FINANCIAL AID
2021–2022 Verification Worksheet
Student:
Last Name
First Name
M.I.
SSN
Cell Phone #
Email Address
Mailing Address
City
State
Zip Code
Family Information:
RSITY
OF
ARKANSAS
= IIDUlff
A)I
~
■
Dependent Student
Independent Student
IF Parent information is required on this form ONLY if the
student was required to provide parental information on the
FAFSA, include the following:
IF Parental information was NOT required on
the FAFSA, include the following:
• Yourself
• Yourself
• Your parent(s) listed on FAFSA and their spouse
• Your spouse, if you are married
• Your parent(s) other children if they will provide more
than half of their support from 7/1/2021 to 6/30/2022
• Your children, if you will provide more
than half of their support from 7/1/2021
to 6/30/2022
• Other people if they now live with your parent(s) and
your parent(s) will provide more than half of their
support through 6/30/2022
• Other people if they now live with you
and you will provide more than half of
their support through 6/30/2022
If more space is needed, attach a separate page with the student’s name and Social Security Number at the top.
Full Name
Age
Relationship
College
Will be Enrolled at
Least Half Time
Marty Jones(example)
28
Wife
Central
University
Yes
Self
UARM
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 is inaccurate.
(See Reverse)
Tax Return Filers: Student (Please read carefully)
We recommend using the IRS Data Retrieval Tool: Go to https://studentaid.ed.gov/sa/fafsa, log in to your FAFSA record, select
“Make a Correction,” and navigate to the Financial Information section of the form. From there follow the instructions to
determine if you are eligible to use the IRS Data Retrieval Tool to transfer 2019 IRS income tax information into your 2021-
2022 FAFSA. Make certain to sign and submit the FAFSA after using the data tool.
Check the boxes that apply to your 2019 Tax Return
Student
Parent
I have used the IRS Data Retrieval Tool in FAFSA on the Web to retrieve and transfer 2019 IRS income
information into the student’s FAFSA, either on the initial FAFSA or when making a correction to the
FAFSA.
I am unable or choose not to use the IRS Data Retrieval Tool in FAFSA on the Web, and instead will
provide the school a 2018 IRS Tax Return Transcript OR a signed copy of 2019 Federal Tax Return
A 2019 IRS Tax Return Transcript may be obtained through the:
• Get Transcript by MAIL – Go to www.irs.gov , under the Tools heading, click “Get Transcript by MAIL.” Make sure
to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
• Get Transcript by ONLINE – Go to www.irs.gov , under the Tools heading, click “Get Transcript ONLINE.” Make
sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
• Automated Telephone Request- 1-800-908-9946
Check the boxes that apply to your 2019 Tax Return
I was not employed and had no income earned from work in 2019
I was employed in 2019 and have listed below the names of all the employers, the amount earned from
each employer in 2019, and whether an IRS W-2 form is attached. Attach copies of all 2019 IRS W-2
forms issued by your employers.
Student/
Parent
Spouse
Employer’s Name
2019 Amount Earned
IRS W-2 Attached?
Certification and Signatures
Tax Return NON Filers: Student (Please read carefully) -
□ □
□ □
□
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Phone:
479.394.7622
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479.
394.5329 I www.uar
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ountain.e
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Suzy’s Auto Body Shop (example)
$2,000.00(example)
Yes(example)
Each person signing this worksheet certifies that all of the information reported is complete and correct
The student and one parent (if
applicable) must sign and date
WARNING: If you purposely give false or
misleading information on this worksheet,
you may be fined, sentenced to jail, or both.
Student’s Signature
Date
Parent’s Signature
Date
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signature
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signature
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Completed 29 January 2021

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