Fillable EMU 2017-2018 Verification Worksheet dependent

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EMU 2017-2018 Verification Worksheet dependent

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The EMU 2017-2018 Verification Worksheet dependent form is 3 pages long and contains:

  • 0 signatures
  • 22 check-boxes
  • 47 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Eastern Michigan University

BROWSE EASTERN MICHIGAN UNIVERSITY FORMS

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1
Student ID E
A.
Student Information
2017-2018 Verification Worksheet
Dependent Student
B.
Household Information
1.
Write the names of all the people in your parent(s)’ household. Include:
Yourself (the student).
Your parent(s). If your parents are divorced, indicate the parent you lived with the most during the last 12
months. If you did not live with one parent more than the other, list the parent who supplied more than half of
your support. Include your step-parent if your parent is remarried. If your legal parents (biological or adopted)
are unmarried but live together, list both parents. Grandparents, foster parents, legal guardians, aunts and
uncles are not considered parents unless they have adopted you.
Your parent(s)’ other children, if your parents will provide more than half of their support between July 1, 2017
and June 30, 2018, or if the children would be required to provide parental information when applying for
federal aid.
Other dependents, if they now live with your parent(s), your parent(s) provide more than half of their support
and will continue to provide more than half of their support between July 1, 2017 and June 30, 2018.
2.
Include the date of birth of each person and their 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
program at least half-time between July 1, 2017 and June 30, 2018.
If 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 parent(s) 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
Submit 2015 1099-R forms (Distributions
from Pensions, Annuities, Retirement or
Profit Sharing Plans, IRSs, Insurance
Contracts, etc.)
DEPVRW
Student ID
E
2
D.
Parent Federal Tax Information
:
Check the box that applies below. Be sure to complete and submit any additional requirements indicated with a
☐
Parent(s) filed a 2015 Federal IRS Tax Return, Puerto Rican, or Foreign Income Tax Return.
☐
Parent(s) was employed and had income, but did not file and was not required to file a 2015 Federal IRS Tax Return.
List all parent(s)’ employers and amount that was earned in 2015 in the chart below.
Submit copies of ALL parent(s) 2015 W-2 statements.
Name of Employer
Amount Earned in 2015
$
Yes
No
$
Yes
No
$
Yes
No
☐
Parent(s) was not employed, did not have income and was not required to file a 2015 Federal IRS Tax Return.
E.
Student Federal Tax Information
Check the box that applies below. Be sure to complete and submit any additional requirements indicated with a
☐
Student filed a 2015 Federal Tax Return, Puerto Rican, or Foreign Income Tax Return.
☐
Student 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 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 was not employed, did not
have income and was not required to file a 2015 Federal IRS Tax Return.
Student ID
E
3
F.
Asset Information
Do not leave blank. Indicate zero or Not Applicable (N/A) if appropriate.
Student Asset
Information
Parent Asset
Information
Each person signing below certifies that all of the information
reported is complete and correct. The student and one parent
whose information was reported on the FAFSA must sign and date.
Student’s Signature Date
Parent’s Signature Date
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
$
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.
$
$
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).
$
$
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 not 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.
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Completed 31 December 2020

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