2019-2020 Dependent Household Size Verification Form
The U.S. Department of Education selected your student’s 2019-2020 FAFSA for verification. Please complete, print, sign, and
submit this form to the Financial Aid Office. Instructions for submission are at the bottom of the form.
A. Student Information
B. Household Information
List the people in your parent(s)’ household. People included in your parent(s) household are as follows:
• Yourself;
• Your parent(s), including a stepparent, even if you do not live with your parent(s);
• Your parent(s)’ other children if your parent(s) will provide more than half of their support from July 1, 2019 through June 30, 2020, or if
the other children would be required to provide parental information when completing a 2019-2020 federal financial aid application
(FAFSA). Include children who meet either of these descriptions, even if they do not live with your parent(s).
• Other people if they now live with your parent(s) and your parent(s) provide more than half of their support and will continue to provide
more than half of their support through June 30, 2020.
If more space is needed attach an additional sheet with the student’s name and ID at the top. The student and parent must sign and date
the additional sheet.
Self
C. Certification and Signatures
Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional information
is attached. The student and one parent MUST sign and date this section.
WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced to jail, or both.
______________________________________________________________________ _______________
Student Signature Required Date
______________________________________________________________________ _______________
Parent Signature Required (If due to the current national situation your parent cannot Date
sign the form, complete section below)
My parent is not able to sign because____________________________________________________________________________
______________________________________________________________________________________ _____________________
Student Initials Required
WAYS TO SUBMIT THIS FORM
(1) Upload this form directly into the Student Information System (SIS) by logging into MY VWCC. Once logged in, go to the Student
Center and select the ‘VWCC 19/20 Dependent # in Coll’ from the ‘To Do List’ list to attach and upload the form. (2) Upload the form
at www.virginiawestern.com
by clicking ‘Contact Us,’ and then clicking the 24/7 Student Support icon. Once you log in you can
submit documents. (3) Fax forms to 540-857-6208
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Phone: (855)874-6690 (Revised 04_2020)
VWCC Student ID - REQUIRED
