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FAC17V5D (Howard Community College)

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  • 72 other fields

Country of origin: US
File type: PDF

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A. Student’s Information
Student’s Last Name Student’s First Name Student’s M.I. Student’s HCC ID Number
B. Family Information
Number of Household Members: List below the people in the parents’ household. Include:
The student.
The custodial 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, 2017, through June 30, 2018, or
if the other children would be required to provide parental information if they were completing a FAFSA for 2017–2018. Include children
who meet either of these standards, even if a child does not live with the parents.
Other people if they now live with the parents and the parents provide more than half of the other person’s support, and will continue to
provide more than half of that person’s support through June 30, 2018.
Student and
Parents
Full Name
Relationship
to student
Date of Birth Marital Status
HCC Student Self
Parent(s),
Stepparent
Parents’ Marital Status
as of Today:
Full Name of Parents’ Other Dependents
All siblings, children, or dependents who meet the criteria above.
If more space is needed, attach a separate sheet.
Relationship
to student
Age
Attending College at least half time?
Household member is, or will be, enrolled at least half time in a degree,
diploma, or certicate program at a Title lV-eligible postsecondary
educational institution any time between July 1, 2017, and June 30, 2018.
Yes No Name of
college:
Yes No Name of
college:
Yes No Name of
college:
Yes No Name of
college:
Yes No Name of
college:
We may require additional documentation if we have reason to believe that the information regarding the household member(s) enrolled in a Title IV-eligible postsecondary educational
institution is inaccurate.
C. High School Completion Status
Your 2017–2018 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called
verication. The law says that, before awarding Federal Student Aid, we must ask you to conrm the information
you reported on your FAFSA. To verify that you provided correct information, we will compare your FAFSA with the
information on this institutional verication document and with any other required documents. If there are dierences,
your FAFSA information may need to be corrected. You and the parent who completed the FAFSA must complete
and sign this institutional verication document, attach any required documents, and submit the form and other
required documents to Financial Aid Services, RCF 222. If you have questions about verication, contact us as
soon as possible so that your nancial aid will not be delayed. Review of submitted documents can take up to
15 business days.
1
2017/2018 V5 Dependent
VERIFICATION WORKSHEET
Provide one of the documents below
to indicate the student’s high school
completion status when the student
begins college in 2017–2018. A student
who is unable to obtain the documen-
tation listed above must contact the
nancial aid oce.
• A copy of the high school diploma.
• For students who completed secondary
education in a foreign country, a copy of
the “secondary school leaving certicate”
or other similar document.
• A copy of the nal ocial high school tran-
script that shows the date of graduation.
• A state certicate or transcript received by a
student after the student passed a state-au-
thorized examination that the state recognizes
as the equivalent of a high school diploma
(GED test, HiSET, TASC, or other state-autho-
rized examination).
• A copy of the DD 214, Member 4 copy.
• An academic transcript that indicates the
student successfully completed at least a two-
year program that is acceptable for full credit
toward a bachelor’s degree.
• For a student who was homeschooled in a
state where state law requires the student to
obtain a secondary school completion cre-
dential for homeschooling (other than a high
school diploma or its recognized equivalent),
a copy of that credential.
• For a student who was homeschooled in a
state where state law does not require the
student to obtain a secondary school comple-
tion credential for homeschooling (other than
a high school diploma or its recognized equiv-
alent), a transcript, or the equivalent, signed
by the student’s parent or guardian, that lists
the secondary school courses the student
completed and includes a statement that the
student successfully completed a secondary
school education in a homeschool setting.
RESET FORM
PRINT
SELECT HERE
HCC ID#
V5–Dependent
2
Financial Aid Services
10901 Little Patuxent Pkwy
Columbia MD 21044
443-518-1260; 443-518-4576 (FAX)
naid@howardcc.edu www.howardcc.edu
CRI: FAC17 V5D
ImageNow Doc type: UG Finaid Verication
FA Doc Name: V-Verication Forms
Work Flow Main: FAS Document Processing
Sub-queue: Academic Year
E. CerticationandSignature
Each person signing below certies 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.
Date:
Student’s Signature
Date:
Parent’s Signature
WARNING: If you purposely give false or misleading information, you may be ned, sent to prison, or both.
You must complete Section F on page 3. 
STUDENT
C. Income and Tax Data for 2015 (The 2017/2018 FAFSA uses 2015 tax information.)
Complete both the student and parent(s) section and provide the required income or tax information.
The quickest way to provide tax information on the 2017/2018 FAFSA is to use the IRS Data Retrieval Tool.
Please note: students and/or parents who submitted 2015 tax return transcripts for 2016/2017 verication at HCC
may use the same transcript to satisfy 2017/2018 verication; however, students and parents are encouraged the
use the IRS data retrieval tool on the 2017/2018 FAFSA.
AMENDED TAXES
If you and/or your parent(s) led or will le an amended 2015
IRS tax return, you must submit:
1) a 2015 IRS Tax Return Transcript of the originally-led
taxes AND
2) a signed copy of the 1040X
VICTIMS OF IDENTITY THEFT
A victim of IRS tax-related identity theft must provide:
1) A Tax Return Database View (TRDBV) transcript obtained
from the IRS, or any other IRS tax transcript(s) that in-
cludes all of the income and tax information required to be
veried; AND
2) A statement signed and dated by the tax ler indicating
that he or she was a victim of IRS tax-related identity theft
and that the IRS is aware of the tax-related identity theft.
TAX FILING EXTENSION
If you and/or your parent(s) have requested a ling exten-
sion, you must submit:
1) a copy of the IRS’s approval of an extension beyond the
automatic six-month extension if the individual requested
an additional extension of the ling time for tax year 2015;
AND
2) a copy of your W-2s or, if self-employed, a signed
statement with the amount of your AGI and U.S.
income taxes paid.
INCOME TAX RETURNS FOR US TERRITORIES AND
POSSESSIONS
A 2015 tax return transcript must be submitted if it is available
for free from the taxing authority.
INCOME TAX RETURNS FOR FOREIGN COUNTRIES
A copy of the 2015 foreign tax return must be submitted if
it is available.
NON-TAX FILERS IN US TERRITORIES AND
POSSESSIONS OR IN A FOREIGN COUNTRY
Non-tax lers in US territories and possessions or in a foreign
country must submit a copy of their Wage and Tax statement
for each source of employment income for 2015 and a signed
statement identifying all income and taxes for 2015.
TAX RETURN TRANSCRIPTS
A 2015 IRS Tax Return Transcript may be obtained through:
1) Online Request at www.IRS.gov. (Under“Tools” menu), or
2) Telephone Request: 1-800-908-9946, or
3) Paper Request: IRS Form 4506T-EZ or IRS Form 4506-T.
Link to the
IRS on your
FAFSA!
OTHER IMPORTANT TAX INFORMATION
Check one box, below, for student’s information.
The student was not employed and had no income earned from work in 2015.
Student must provide documentation of nonling from the IRS (use IRS form 4506-T)
The student was employed in 2015 but did not le taxes.
Student must complete the table, below; AND
Student must provide copies of all 2015 IRS W-2 forms, if issued by employers; AND
Student must provide documentation of nonling from the IRS (use IRS form 4506-T).
The student was employed in 2015 and led taxes.
Student has used/will use IRS DATA Retrieval Tool on FAFSA. OR
Student has provided/will provide 2015 Federal Tax Return Transcript from the IRS.
PARENT
Check one box, below, for parents’ information.
Neither parent was employed, and neither had income earned from work in 2015
Parent(s) must provide documentation of nonling from the IRS (use IRS form 4506-T)
One or both parents were employed in 2015 but parent(s) did not le taxes.
Parent(s) must complete the table, below; AND
Parent(s) must provide copies of all 2015 IRS W-2 forms issued by employers; AND
Parent(s) must provide documentation of nonling from the IRS (use IRS form 4506-T).
One or both parents were employed in 2015 and parent(s) led taxes.
Parent(s) has used/will use IRS DATA Retrieval Tool on FAFSA. OR
Parent(s) has provided/will provide 2015 Federal Tax Return Transcript(s) from the IRS.
Employer’s Name
2015 Amount
Earned
IRS W-2
Attached?
Examples: CVS or yard work for Mrs. Lee Example: $275 Yes or No
Parent’s Name Employer’s Name
2015 Amount
Earned
IRS W-2
Attached?
Example: John Jones Example: Suzy’s Car Wash Example: $2,000 Yes or No
Fill in this table ONLY if you did not file 2015 taxes.
Fill in this table ONLY if your parents did not file 2015 taxes.
F. StatementofEducationalPurposeandCerticationofIdentity
• This statement must be completed and signed in the presence of an HCC Financial Aid Representative.
• Do not complete form in advance!
HCC ID#
V5–Dependent
Statement of Educational Purpose
I certify that I am the individual signing this
Print Student’s Name
Statement of Educational Purpose and that the Federal student nancial assistance I may
receive will only be used for educational purposes and to pay the cost of attending
Howard Community College for 2017-2018.
Student’s Signature
Date
Student’s HCC ID Number
The student must appear in person at Howard Community College’s Financial Aid Services to verify his or
her identity by presenting an unexpired valid government-issued photo identication (ID), such as, but not limited
to, a driver’s license, other state-issued ID, military ID, or passport. The institution will maintain a copy of the
student’s photo ID that is annotated by the institution with the date it was received and reviewed, and the name of
the ocial at the institution authorized to receive and review the student’s ID.
In addition, the student must sign, in the presence of the institutional ocial, the Statement of Educational
Purpose provided below.
Verication of Government-Issued ID
OFFICE USE ONLY: To be completed by HCC Financial Aid Representative.
ID Type: □ Driver’s License □ Non-Driving State ID □ Passport □ Other
ID Number: Expiration date:
FAA Name:
FAA Title:
FAA Signature:
Date:
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Completed 27 July 2020

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