Fillable EMU 2017-2018 Verification Worksheet Independent Student

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EMU 2017-2018 Verification Worksheet Independent Student

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The EMU 2017-2018 Verification Worksheet Independent Student form is 2 pages long and contains:

  • 0 signatures
  • 13 check-boxes
  • 36 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Eastern Michigan University

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1
A.
Student Information
B.
Household Information
1.
Write the names of all the people in the student’s household. Include:
The student (yourself)
Your spouse, if you are married.
Your or your spouse’s children, if you or your spouse will provide more than half of their support July 1, 2017
and June 30, 2018, even if the children do not live with you.
Other people, if they now live with you and your spouse provides more than half of their support and will
continue to provide more than half of their support through June 30, 2018.
2.
Include the date of birth of each person and his or her relationship to you (the student).
3.
Add the name of the college for any household member who will be enrolled in a degree, diploma, or certificate
pr
ogram at least half-time between July 1, 2017 and June 30, 2018.
I
f more space is needed, provide a separate page with your name and EMU ID number at the top.
Full Name
Date of birth
Relationship to you
Name of College
1.
Self
Eastern Michigan University
2.
3.
4.
5.
6.
C.
Untaxed IRA Distributions & Pensions (Rollover)
Did you (the student) or your spouse report any Rollover IRA Distributions or Pensions on your 2015 Federal Tax Return
1040 (lines 15a and 16a) or 1040A (lines 11a and 12a)?
Yes. Please submit the following:
No. Proceed to Section D.
Indicate any rollover amounts for 2015
2015 1099-R forms (Distributions from
Pensions, Annuities, Retirement or Profit
Sharing Plans, IRSs, Insurance Contracts,
etc.)
Student ID E
INDVRW
2017-2018 Verification Worksheet
Independent Student
2
Office of Financial Aid
In-Person locations: Service EMU 240 McKenny Hall | 268 Student Center
Email: financial_aid@emich.edu | Fax: (734) 487-4281
Mailing Address: 403 Pierce Hall, Ypsilanti, MI 48197
www.emich.edu/finaid
*Do not leave blank. Indicate zero or Not Applicable (N/A) if appropriate.*
D.
Student Federal Tax Information
Chec
k the box that applies below. Be sure to complete and submit any additional requirements indicated with a
☐
Student (and spouse, if married) filed a 2015 Federal Tax Return, Puerto Rican, or Foreign Income Tax Return.
☐
Student (and spouse, if married) was employed and had income, but did not file and was not required to file a 2015
Federal IRS Tax Return.
List all employers and amount that was earned in 2015 in the chart below.
Submit copies of ALL student (and spouse) 2015 W-2 statements.
Name of Employer
Amount Earned in 2015
2015 W-2 Form received from
employer?
$
Yes
No
$
Yes
No
$
Yes
No
☐
Student (and spouse, if married) was not employed, did not
have income and was not required to file a 2015 Federal
IRS Tax Return.
E.
Asset Information
Student
’s Signature Date
1.
As of the date you filed the 2017-2018 FAFSA, what is your total current balance of cash, savings and checking accounts?
Do not include student financial aid.
$ __________________
2.
As of the date you filed the 2017-2018 FAFSA, what is the net worth of your investments, including real estate? Net worth
means current value minus
debt.
Investments include: real estate (do not include the home in which you live), rental property, trust
funds, UGMA/UTMA accounts, money market funds, mutual funds, certificates of deposit, stocks, stock options, bonds, other
securities, Coverdell savings accounts, 529 college savings plans. Do not include the value of life insurance; retirement plans (pension
funds, annuities, non-educational IRAs, Keogh plans, etc).
$ __________________
3.
As of the date you filed the 2017-2018 FAFSA, what is the net worth of your current businesses and/or
investment farms?
Business or farm value includes the current market value of land, buildings, machinery, equipment,
inventory, etc. Do not include the net worth of a family owned and controlled small business with no more than 100 full-time or
full-time equivalent employees.
$ __________________
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to jail, or both.
Student ID E ___________________
Signing below certifies that all of the information reported is
complete and correct. The student must sign and date.
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EMU 2017-2018 Verification Worksheet Independent Student

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Completed 29 December 2020

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