Revised
01/2020
Copper
Mountain
College 2020-2021 Dependent Student
Verification
Student's Last Name
First Name M.l. Student's CMC ID
Number
READ THIS: Dependent
Student's
Family
Information
**Dependent
students must include both of the
dependent
student's legal (biological or adoptive) parents if the parents live together, regardless of
the
marital status or gender of the
parents.
List the people in the parents'
household
below. Include:
The
student
The parents (including a stepparent) even if the student doesn't live with the
parents
The parents' other children if the parents will provide more than half of the children's support from July 1, 2020, through
June
30,
2021, or if the other children would be required to provide parental information if they were completing a FAFSA for
2020-2021.
Include children who meet either of these standards, even if they do not live with the
parents.
Other people if they now live with the parents and the parents provide more than half of their support and will continue to
Provide
more than half of their support through June 30,
2021.
Full
Name
Age
Relationship
College
*Going
to
college at least
Half
Time
(Yes
or
No)
Me
Copper Mountain
College
Parent
1
Paren
t
2
.
* Note:
We
may
require proof
of
enrollment
for
household
members.
Student Tax Filers VERIFICATION If you filed
taxes:
Check the box that
applies:
D
The student has used the IRS
DRT
in
FAFSA
on
the Web to transfer 2018 IRS income tax return information into the student's FAFSA.
D
The student
is unable or chooses not to use the IRS
DRT
in FAFSA
on
the Web,
and instead
will
provide
the
school
a
2018 IRS
Tax
Return
Transcript
(signature not
required)
D
The student filed an
amended tax return for
the
tax
year 2018 must
provide:
1. A
2018JRS Tax Return Transcript (does not need
to be
signed)
,
and
2. A
signed copy
of
the 2018 IRS
Form
1040X, Amended U.S.
Individua
l
Income
Tax
Return. that
was
filed
with
the
IRS
D
The student was required
to file a
2018
IRS
tax return and has been granted
a Filing Extension by
the
IRS,
must
provide:
1. A
copy of IRS
Form
4868, "Application
for
Automatic Extension
of
Time
to
File U.S.
Individua
l
Income
Tax
Return," that was filed with
the IRS for tax year 2018;
2. A
copy
of
the
IRS's
approval
of an
extension beyond
the
automatic six-month extension for
tax year 2018;
3.
Verification
of
Non-filing Letter from
the
IRS dated after October
1, 2018;
4. A
copy
of
IRS Form
W-2 for
each source
of
employment income received
for tax
year 2018
and,
5. If
self-employed,
a
signed statement certifying
the
amount
of
the individual's Adjusted Gross Income (AGJ)
and
the
U.S. income tax
paid
for
tax year 2018
D
Victim of
Tax-Related
Identity
Theft
-
must
provide:
1. A Tax
Return DataBase View (TRDBV) transcript obtained from the IRS,
or
any other
IRS tax
transcript
that
includes
all of
the income and
tax
information required
to be
verified;
and
2. A
statement signed and dated
by the tax
filer indicating that he/she was
a
victim of
IRS
tax-related
identity
theft and that
the
IRS
is
aware
of the
tax-related identity
theft.
What you need to get
an
On-Line Transcript: 1)
SSN
# 2)
date
of
birth
3)
filing status and mailing address from latest
tax
return
4)
access
to your
email account
5)
your personal
account#
from
a
credit card, mortgage, home equity
Joan, home equity line
of
credit
or
car loan, and
6) a
mobile
phone
with your name
on the account.
Revised
01/2020
Non-Tax
Filer
s
:
Complete this section
i
f
the student will not file and is not required to file a 2018 income tax return with the IRS.
Check the box that
applies:
The student was not
emp
l
oye
d
and had no income earned from work in
2018
.
The student was
employed
in 2018 and has listed below the names of all
employers,
the amount earned from each employer in 2018,
and
whether
an IRS W-2 form is
provided
.
(
P
rovide
copies of all 2018 IRS W-2 forms
i
ssued
to the student by his/her
employers
.
Employer’s Name 2018 Amount Earned IRS W-2 Provided?
EXAMPLE ONLY – Spike’s Auto Body Shop $2,000 Yes

Parent
Section
Taxes Filed? - See
instructions
on Page
1
^^^^^
Important
Not
e
:
The instructions apply to each parent included in the
household
.
Non-Tax
Filer
s
:
The instructions and certifications below apply to each parent included in the household. Complete this section if
the
parents will not file and are not
required
to
f
il
e
a 2018 income tax return with the
IRS
.
Check the box that
applies
:
Neither parent was
employed
nor had any
i
n
come
earned from work in
2018
.
One or both parents were
employed
in 2018 and have listed the names of all
employers,
the amount earned from each employer in
2018
,
an
d
whether an IRS W-2 form
i
s
prov
i
ded
.
Pro
v
i
de
copies of all 2018 IRS W-2 forms issued to the parents by
th
e
i
r
employers
.
Employer’s Name 2018 Amount Earned IRS W-2 Provided?
EXAMPLE ONLY – Spike’s Auto Body Shop $2,000 Yes

Not
e
:
Provide
a Verification of
Non-filing
from the IRS dated on or after October 1, 2018 that indicates a 2018
I
R S Income tax
return
was not filed with the
I
R
S
.
Go to
https:l/www.irs.gov/pub/irs-pdf/f4506t.pdf
Check boxes 7 and
8
.
Certification
and
Signature
WARNING: If you
purposely
give false or
misleading information
on this
worksheet,
you may be fined,
sent
to
prison,
or
both.
Each person signing below certifies that all of the information reported is complete and correct. The student and parent
must sign this worksheet.
Student's Signature
Date
Parent's Signature
Date
Submit this Worksheet to the Financial Aid Office at CMC or attach in an email through MyCMC Portal.
click to sign
signature
click to edit
click to sign
signature
click to edit