Dr. H.A. Miller Student Services Center
417 Schepps Blvd | Clovis, NM 88101
Ph. (575) 769-4060 | Fax (575) 769-4027
CCC ID:
BAS Verification
2019-2020
Name:
Independent Student:
Were you active duty military during 2017?
Enlisted member
How many months? ____
Was your spouse active duty military during 2017? How many months? ____
NO
Officer
Was your father active duty military during 2017?
Enlisted member
How many months?
Was your mother active duty military during 2017? How many months?
YES
Enlisted member
A calculation of BAS received during 2017 will be performed based on the information provided
above, multiplied by the following, based on Enlisted or Officer rates;
Category Monthly Allowance
Enlisted Members $367.92
Officers $253.63
Are any of the following currently active duty military?
○ Self ○ Spouse ○ Father ○ Mother
Note: If the above information was not provided on your 2019-2020 FAFSA, a correction will be sent to the Federal
Processing Center to include it.
SIGNATURE REQUIRED
By signing this statement, you certify that all of the information reported on it is complete and correct.
Warning: If you purposely give false or misleading information on this worksheet you can be fined, sentenced to jail, or both.
Student Signature: Date:
Parent Signature: Date:
Financial Aid Specialist: Date:
Correction Sent: ____________________
Correction Received:_______________
Transaction Number:______________________
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