Northwest State Community College • 22600 State Route 34 • Archbold • OH • 43502
Phone: 419-267-1333 • Fax 419-267-5587 • finaid@northweststate.edu
Your FAFSA was randomly selected by the U.S. Department of Education for a review process called “Verification.Verification must be
completed before your financial aid awards will be determined. If there are differences between your FAFSA and this information, we will
update your FAFSA and recalculate your Expected Family Contribution (EFC). Complete verification as soon as possible so that your financial
aid won’t be delayed.
A. Student Information
Last Name First Name M.I
NSCC ID Number
Street Address (include apt. no.)
Date of Birth
City, State, Zip Code
Phone Number
B. Household Information
List the people you will support between July 1, 2019 and June 30, 2020. Include:
Yourself and your spouse (if you are married)
Your children, if you (or your spouse) provide more than half of their support, even if they don’t live with you.
Other people if they now live with you and you now provide more than half of their support and will continue to provide more
than half of their support through June 30, 2020.
Write the name of the college below for any household member who will be enrolled at least half time in a degree, diploma, or
certificate program at an eligible postsecondary educational institution any time between July 1, 2019, and June 30, 2020.
If more space is needed, attach a separate page with the student’s name and student ID at the top.
Household member name
Age
Relationship to student
College (if attending)
Will be enrolled
at least half-time
(c
heck Yes or No)
1.
SELF
NSCC
Yes No
2.
Yes No
3.
Yes No
4.
Yes No
5.
Yes No
C. Student Income Information
Student Marital Status: ______ Single ______ Married /Remarried ______ Separated/Divorced/Widowed
Check one of the following:
_____ Student filed a 2017 Federal Income Tax return.
____ I used the FAFSA IRS Data Retrieval Tool ____ I ordered an IRS Tax Return Transcript ____Provide a signed copy of 2017 Form 1040
_____ Student was not employed and had no income from work in 2017. Must provide Verification of Non-Filing Letter from IRS.
_____ Student was employed in 2017 and did not file taxes, and is not required to file a tax return. Please complete the table below.
You are required to attach copies of all 2017 IRS W-2 forms issued to the student if not filing a federal tax return. List every
employer even if they did not issue an IRS W-2. Must provide Verification of Non-Filing Letter from IRS.
Employer’s Name
2017 Amount
Earned
2017 W-2
Attached?
Example: ABC Company
$1,005.75
Yes
By signing this worksheet, I certify that all the information reported on it is completed and correct.
Student Signature
Date
2019-2020 Independent Student
Verification Group V1
Northwest State Community College • 22600 State Route 34 • Archbold • OH • 43502
Phone: 419-267-1333 • Fax 419-267-5587 • finaid@northweststate.edu
Student Name:
NSCC ID number:
D. Spouse Income Information (if married, but filed taxes separate)
Check one of the following:
_____ Spouse filed a separate 2017 Federal Income Tax return.
_____ I ordered an IRS Tax Return Transcript _____ Provide a signed copy of 2017 Form 1040
_____ Spouse was not employed and had no income from work in 2017. Must provide Verification of Non-Filing Letter from IRS.
_____ Spouse was employed in 2017 and did not file taxes, and is not required to file a tax return. Please complete the table below.
You are required to attach copies of all 2017 IRS W-2 forms issued to the student if not filing a federal tax return. List every
employer even if they did not issue an IRS W-2. Must provide Verification of Non-Filing Letter from IRS.
Employer’s Name
2017 Amount
Earned
2017 W-2
Attached?
Example: ABC Company
$1,005.75
Yes
By signing this worksheet, I certify that all the information reported on it is completed and correct.
Spouse Signature
Date
E. Tax Information
Both the student and the spouse are required to submit processed 2017 Federal Tax information. The only acceptable
methods to submit tax information are listed below:
IRS Data Retrieval Tool Directly import your 2017 IRS data into your 2019-20 FAFSA by logging into fafsa.ed.gov and
select “Make Correction”.
Keep in mind that if you are married, but filed taxes separately, the data retrieval tool will not work and you will need to
order tax return transcripts for both the student and the spouse (see information below).
IRS Tax Return Transcript Submit your 2017 Tax Return Transcript. You can order the transcript by online at irs.gov or by
phone at 1-800-908-9946. Please make sure you select an IRS Tax Return Transcript NOT the IRS Account Transcript.
Also accepting a signed copy of 2017 Form 1040.
Verification of Non-Filing Letter If the student or spouse did not file 2017 taxes, and are not required to file taxes, then they
must complete and return a Verification of Non-filing Statement Form and request a Verification of Non-Filing Letter from the
IRS by submitting IRS Form 4506-T, check marking box 7.
Amended Taxes -- If the student or spouse filed an amended 2017 IRS tax return, please submit your original 2017 IRS Tax
Return Transcript and a signed copy of the 2017 IRS Form 1040X that was filed with the IRS.
Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion
or age in its programs or activities.