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FAC18V5I (Howard Community College)

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Your 2018–2019 FAFSA was selected for review in a process called verication. To verify that you provided
correct information, we will compare your FAFSA with the information on this institutional verication docu-
ment and with any other required documents. If there are dierences, your FAFSA information may need to
be corrected. Review of submitted documents can take up to 15 business days.
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 student’s household. Include:
The student.
The student’s spouse, if the student is married.
The student’s or spouse’s children if the student or spouse will provide more than half of the children’s support from July 1, 2018, through
June 30, 2019, even if a child does not live with the student.
Other people if they now live with the student and the student or spouse provides 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, 2019.
Household
Members
Full Name
Marital Status
as of today
Age
Attending college at least ½ time?*
Check “yes” for any household member who is, or will be, enrolled
at least half time in a degree, diploma, or certicate program at an
eligible postsecondary educational institution any time between
July 1, 2018, and June 30, 2019. Include the name of the college.
HCC Student
Student’s
date of birth:
Spouse
Yes No
Name of college:
Household
Members
Full Name
Relationship
to student
Age
Will be enrolled in college at least half time?
*
All children or
dependents
who meet the
criteria above.
If more space is
needed, attach a
separate sheet.
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:
Yes No
Name of college:
Yes No
Name of college:
Note: We may require additional documentation if we have reason to believe that the information regarding the household members enrolled in Title lV-eligible postsecondary institutions is inaccurate.
1
2018/2019 V5 Independent
VERIFICATION WORKSHEET
C. Current Net Worth
Please report the requested information as of the date the student led the 2018-2019 FAFSA. Net worth means the current value
of an asset minus debt. If you do not have any assets in that category, enter $0. If the net worth is negative, enter $0.
Net Worth of Cash,
Savings, and
Checking Accounts
Net Worth of
Investment*
Net Worth
of Business/
Investment Farm**
Net Worth
of Student
Net Worth
of Spouse
* Net Worth of Investment
Includes real estate (not including the home you live in),
trust funds, UGMA/UTMA accounts, money market funds,
mutual funds, CD’s, stocks, stock options, bonds, installments
and land sale contracts (including mortgages held), and
commodities. Include qualied education benets or savings
accounts—if owned by student, report as a parental asset.
** Net Worth of Business/ Investment Farm
Don’t include a family farm or family business with 100 or
fewer full-time or full-time-equivalent employees.
RESET FORM
PRINT
HCC ID#
V5–Independent
D. Income and Tax Data for 2016
VERIFICATION OF 2016 INCOME FOR STUDENT
Student resided in a FOREIGN COUNTRY in 2016.
S
tudent will complete Foreign Income Supplement, even if no income was
earned, and provide documentation. (Office use only: insert FAC18FID in CRI.)
Student was employed in 2016 and led US taxes.
Student has used/will use IRS DATA Retrieval Tool on FAFSA. OR
Student has provided/will provide 2016 Federal Tax Return Transcript from IRS.
Student was not employed in the US and no income was earned
from work in 2016.
Student will provide statement of nonling from the IRS (use IRS form 4506-T)
Student was employed in the US in 2016 but did not le taxes.
Student will provide copies of all 2016 IRS W-2 forms, if issued by employers; AND
Student must complete the table, below:
VERIFICATION OF 2016 INCOME FOR SPOUSE, IF MARRIED
My spouse resided in a FOREIGN COUNTRY in 2016.
S
pouse will complete Foreign Income Supplement, even if no income was
earned, and provide documentation. (Office use only: insert FAC18FID in CRI.)
My spouse was employed in 2016 and led US taxes.
Spouse has used/will use IRS DATA Retrieval Tool on FAFSA. OR
Spouse has provided/will provide 2016 Federal Tax Return Transcript from IRS.
My spouse was not employed in the US and no income was earned
from work in 2016.
Spouse will provide statement of nonling from the IRS (use IRS form 4506-T)
My spouse was employed in the US in 2016 but did not le taxes.
Spouse will provide copies of all 2016 IRS W-2 forms, if issued by employers; AND
Spouse must complete the table, below:
Verication of Income
for Individuals with Unusual
Circumstances
An individual who is required to le
a 2016 IRS income tax return and has
been granted a ling extension by the
IRS beyond the automatic six-month exten-
sion for tax year 2016, must provide:
• A copy of IRS Form 4868, Application for
Automatic Extension of Time to File U.S.
Individual Income Tax Return, that was
led with the IRS for tax year 2016;
• A copy of the IRS’s approval of an exten-
sion beyond the automatic six-month
extension for tax year 2016;
• Verication of Non-ling Letter
(conrmation that the tax return has not
yet been led) from the IRS or other
relevant tax authority dated on or after
October 1, 2017;
• A copy of IRS Form W–2 for each source
of employment income received or an
equivalent document for tax year 2016
and,
• If self-employed, a signed statement
certifying the amount of the individual’s
Adjusted Gross Income and the U.S.
income tax paid for tax year 2016.
An individual who led an amended
IRS income tax return for tax year 2016
must provide:
• A 2016 IRS Tax Return Transcript (that
will only include information from the
original tax return and does not have
to be signed), or any other IRS tax
transcript(s) that includes all of the in-
come and tax information required to be
veried; and
• A signed copy of the 2016 IRS Form
1040X, “Amended U.S. Individual
Income Tax Return,” that was led
with the IRS.
An individual who was the victim of IRS
tax-related identity theft must provide:
• A Tax Return DataBase View (TRDBV)
transcript obtained from the IRS, or any
other IRS tax transcript(s) that includes
all of the income and tax information
required to be veried; and
• 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
If you are eligible to use the IRS Data Retrieval Tool, it’s the
easiest way to provide tax data on the 2018/2019 FAFSA.
DO NOT COMPLETE THIS TABLE
IF YOU FILED TAXES!
Employer’s Name
IRS W-2 or an
Equivalent Document
Provided?
Annual Amount
Earned in 2016
Total Amount Earned From Work in 2016
DO NOT COMPLETE THIS TABLE
IF YOU FILED TAXES!
Spouse’s Employer’s Name
IRS W-2 or an
Equivalent Document
Provided?
Annual Amount
Earned in 2016
Total Amount Earned From Work in 2016
$ 0.00
$ 0.00
C. High School Completion Status
Provide one of the following documents to indicate the student’s high school completion status when the student be-
gins college in 2018–2019:
• A copy of the student’s 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 student’s nal ocial high school transcript that shows the date when the diploma was awarded.
• A State certicate or transcript received by a student after the student passed a State-authorized examination that
the State recognizes as the equivalent of a high school diploma (GED test, HiSET, TASC, or other State-authorized
examination).
• 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 credential 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 completion credential for homeschooling (other than a high school diploma or its recognized equivalent), 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
.
A student who is unable to obtain the documentation listed above must contact the nancial aid oce.
E. Certication and Signature
Each person signing below certies 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
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 4. 
Financial Aid Services
10901 Little Patuxent Pkwy
Columbia MD 21044
443-518-1260; 443-518-4576 (FAX)
finaid@howardcc.edu www.howardcc.edu
CRI: FAC18V5I
ImageNow Doc type: UG Finaid Verication
FA Do
c Name: V-Verication Forms
Work Flow Main: FAS Document Processing
Sub-queue: Academic Year
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–Independent
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 2018-2019.
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, 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 22 July 2020

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