1
A.
Student Information
B.
Household Information

Write the names of all the people in the student’s household. Include:
9
The student (yourself)
9
Your spouse, if you are married.
9
Your or your spouse’s children, if you or your spouse will provide more than half of their support July 1, 201
and June 30, 20, even if the children do not live with you.
9
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, 20.

Include the date of birth of each person and his or her relationship to you (the student).

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, 201 and June 30, 20.
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 spouse report any Rollover IRA Distributions or Pensions on your 201 Federal Tax Return
1040 (lines 15a and 16a) or 1040A (lines 11a and 12a)?
No. Proceed to Section D.Yes. Please submit the following:
Indicate any rollover amounts for 201
201 1099-R forms (Distributions from
Pensions, Annuities, Retirement or Profit
Sharing Plans, IRSs, Insurance Contracts,
etc.)
Student ID E
INDVRW
201-20 Verification Worksheet
Independent Student
2
Office of Financial Aid
In-Person locations: Service EMU 268 Student Center
Email:
financial_aid@emich.edu | Fax: (734) 487-4281
Mailing Address: 403 Pierce Hall, Ypsilanti, MI 48197
www.emich.edu/finaid
D.
Student Federal Tax Information
Check the box that applies below. Be sure to complete and submit any additional requirements indicated with a
9
Name of Employer Amount Earned in 201
201 W-2 Form received from
employer?
$
Yes
No
$
Yes
No
$
Yes
No
E.
Asset Information
Student’s Signature Date

As of the date you filed the 201-20 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 201-20 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 201-20 FAFSA, what is the net worth of your current businesses and/orinvestmentfarms?
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 orfull-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.
܆
Student (and spouse, if married) filed a 201 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
201Federal IRS Tax Return.
9
List all employers and amount that was earned in 201 in the chart below.
9
Submit copies of ALL student (and spouse) 201 W-2 statements.
9
You must also submit a Verification of Non-Filing Letter from the IRS. (Please see page for instructions on
ordering a Non-Filing Letter)
܆
Student (and spouse, if married) was not employed, did not have income and was not required to file a 201 Federal
IRS Tax Return.
9
You must also submit a Verification of Non-Filing Letter from the IRS. (Please see page for instructions on
ordering a Non-Filing Letter)
*Do not leave blank. Indicate zero or Not Applicable (N/A) if appropriate.*
Instructions for completing IRS Data Retrieval Tool and ordering IRS documents
IRS Data Retrieval instructions
Log in to your current FAFSA or start a new FAFSA at fafsa.gov.
In the finances section of the FAFSA, you will see a “Link to IRS” button if you are eligible to use theDRT.
Click the “Link to IRS” button and log in to the IRS to retrieve your tax return information.
Review your tax return information, and see the tax data that will be transferred into your FAFSA.
Check the “Transfer My Tax Information into the FAFSA” box, and click the “Transfer Now” button.
Review your federal tax return information that has been transferred into the data fields on your FAFSA.
Both students and parents can use the IRS DRT. To learn more about the IRS DRT, visit StudentAid.gov/irsdrt.
201 IRS Tax Return Transcript Request Instructions
Get Transcript by MAIL
(5-10 calendar days)
preferred method
Get Transcript by Phone
(5-10 business days)
Get Transcript Online
(Immediate access, but can
be challenging)
Request Online:
KWWSVZZZLUVJRYLQGLYLGXDOVJHWWUDQVFULSW
SSN or ITIN
Birthdate
Mailing Address from your last tax return
Request Return Transcript
or
Paper Request Form 4506-T
Download the form at
https://www.irs.gov/SXE/LUVSGIIWSGI
Complete items 1a - 4
Check Line 6(a) Return Transcript Sign
and date the form
Dial: 1-800-908-9946
SSN
Street Address (number only)
Select “Option 2” to request an IRS
Tax Return Transcript for 201.
The tax transcript will be mailed to the
address reported on the tax return.
Visit:
KWWSVZZZLUVJRYLQGLYLGXDOVJHW
WUDQVFULSW
First time users will need to register
and provide the following
Required information:
Full Name
Email
Birthdate
SSN or ITIN
Tax Filing Status
Current Address
Mobile Account/Phone
Mailing address for Michigan residents only
IRS RAIVS Team
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*Other states please refer to the instruction
sheet on the 4506-T form.
and one of the following
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Credit Card, or
Mortgage or Home Equity
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201 Verification of Non-Filing Letter Request Instructions
Download the 4506-T form at https://www.irs.gov/SXE/LUVSGIIWSGI
Complete items 1a - 4
Check line 7 (Verification of Non-Filing)
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Sign and date the form
Mail the completed form to
Receive letter in 5-10 calendar days
Mailing Address for Michigan residents only
IRS RAIVS TEAM
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*Other states please refer to the instruction sheet on the 4506-T form.
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