Fillable A. Student Information (Northwest State Community College)

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A. Student Information (Northwest State Community College)

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U.S.A. forms for Northwest State Community College

BROWSE NORTHWEST STATE COMMUNITY COLLEGE FORMS

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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 your parent(s) will support between July 1, 2019 and June 30, 2020. Include:
Yourself and your parents (including a stepparent) even if you don’t live with your parents.
Your parent’s other children if (a) your parent(s) provide more than half of their support, or (b) if the other children would be
required to provide parental information were they to complete a FAFSA for 2019-2020. Include children who meet either of
these standards, even if they do not live with your parent(s).
Other people if they now live with your parent(s), and your parent(s) 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, excluding your parent(s), 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
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.
_____ 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.
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 Dependent 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. Parent(s) Income Information
Parent(s) Marital Status:
___ Single ___ Married/Remarried ___ Separated/Divorced/Widowed ___Unmarried, both parents living together
Check one of the following:
_____ Parent(s) filed a 2017 Federal Income Tax return.
____ Parent(s) used the FAFSA IRS Data Retrieval Tool ___ Parent(s) ordered an IRS Tax Return Transcript ___ Provide a signed copy
of 2017 Form 1040
_____ Parent(s) was not employed and had no income from work in 2017. Must provide Verification of Non-Filing Letter from IRS.
_____ Parent(s) 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.
Parent Signature
Date
E. Tax Information
Both the student and the parent(s) 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.gov and select
“Make Correction”. Make sure to use the Data Retrieval Tool for both the student and the parent.
Keep in mind that if your parent’s are married, but filed taxes separately, the data retrieval tool will not work and you will
need to order tax return transcripts for each parent (see information below).
IRS Tax Return Transcript – Submit your 2017 Tax Return Transcript. You can order the transcript by online at irs.gov or via
automated telephone request by calling 1-800-908-9946. You may also complete IRS Form 4506-T and check mark box 6a.
Please make sure you request 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 your parent(s) 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 parent 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.
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Completed 3 October 2020

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