(PURPLE) 15-16 Child Support PAID Form 2/27/2015
Financial Aid Office P.O. Box 804 Spindale, NC 28160
Child Support PAID Verification Form – 2015-2016
You must complete this form if you or your spouse, if married, or your parent(s)/stepparent, if dependent, reported paying child
support in 2014 on your Free Application for Federal Student Aid (FAFSA).
Student Name: ________________________________________ Student ID: ________________________
No, neither I nor my spouse, if married, or my parent/stepparent, if dependent, PAID child support in 2014.
(Mark the box and skip to signatures below)
INDEPENDENT STUDENTS: Complete this section if you or your spouse PAID child support in 2014.
Yes, either I, or if married, my spouse, PAID child support in 2014. I have indicated below the name of the person
who paid the child support, the name of the person to whom the child support was paid, the names of the children for
whom child support was paid, and the total annual amount of child support that was paid in 2014 for each child. If
asked by my school, I will provide documentation of the payment(s) of child support. If you need more space, attach a
separate page that includes your name and Student ID# at the top.
Name of Person Who PAID
Child Support
Name of Person to Whom Child
Support was PAID
Name of Child for Whom
Support Was PAID
Amount of Child
Support PAID in
2014
DEPENDENT STUDENTS: Complete this section if one of your parents/stepparent PAID child support in 2014.
One (or both) of my parents/stepparent PAID child support in 2014. The parent has indicated below the name of the
person who PAID the child support, the name of the person to whom the child support was paid, the names of the
children for whom child support was paid, and the total annual amount of child support that was paid in 2014 for each
child. If asked by the school, I will provide documentation of the payment of child support. If you need more space,
attach a separate page that includes the student’s name and Student ID# at the top.
Name of Person Who PAID
Child Support
Name of Person to Whom Child
Support was PAID
Name of Child for Whom
Support Was PAID
Amount of Child
Support PAID in
2014
Certification and Signatures
Each person signing this worksheet certifies that all of the information
reported on it is complete and correct.
________________________________________________________ _____________________________
Student’s Signature Date
________________________________________________________ _____________________________
Spouse’s Signature (if married) or Parent’s Signature (if dependent) Date
WARNING: If you purposely give false or
misleading information you may be fined,
sentenced to jail, or both.
