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FAC19VSD (Howard Community College)

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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:
Yourself.
Your custodial parents (including a stepparent), even if you do not live with your parents.
Do not include a non-custodial parent not living in the household as a result of separation or divorce.
Your parents’ other children if;
(a) your parents will provide more than half of the children’s support from July 1, 2019 through June 30, 2020, or
(b) if the other children would be required to provide parental information if they were completing a FAFSA for 2019–2020.
Include children who meet either of the standards described above, even if a child does not live with the parents.
Do not include children for whom child support is paid or foster children supported by another entity.
Provide college information for those students attending at least half-time during 2019-20 in a program leading to a degree,
diploma, or certicate.
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 from July 1, 2019 through June 30, 2020.
Full name of student Date of birth
Full name(s) of parent(s)/stepparents
Relationship
to student
Date of Birth Parents’ marital status as of today
Married/remarried on Widowed
Mont h/ Year
Divorced/separated on Never
Mont h/ Year
Married
Unmarried but parents live together
Full name of parents’ children/stepchildren
Relationship
to student
Age Enrolled in college at least half time?
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Yes No College:
Full Name of others in household for whom
parent(s) provide more than 50% support
Relationship
to student
Age Enrolled in college at least half time?
I certify that I provide more than 50% support for the individuals listed below and they
do not receive any additional state or federal benets, ie. disability, pension, or retirement.
Parent Signature
Yes No College:
Yes No College:
Yes No College:
Your 2019–2020 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 document 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.
2019/2020
Supplemental Dependent
VERIFICATION WORKSHEET
1
PRINT
RESET FORM
HCC ID#
VSD–Supplemental Dependent
E. CerticationandSignature
Each person signing below certies that all of the information reported is complete and correct.
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.
Financial Aid Services
10901 Little Patuxent Pkwy
Columbia MD 21044
443-518-1260; 443-518-4576 (FAX)
naid@howardcc.edu www.howardcc.edu
CRI: FAC19VSD
ImageNow Doc type: UG Finaid Verication
FA Doc Name: V-Verication Forms
Work Flow Main: FAS Document Processing
Sub-queue: Academic Year
C. 2017IncomeandTaxData
Verication of Income for Individuals with Unusual Circumstances, page 3, addresses ling extentions, amended taxes and identity theft.
VERIFICATION OF 2017 INCOME FOR STUDENT
Student was employed in a FOREIGN COUNTRY in 2017.
Student will complete Foreign Income Supplement (under parents’ Information) and provide documentation.
(Oce use only: insert FAC19FID in CRI.)
Student was employed in 2017 and led US taxes.
Student has used/will use IRS DATA Retrieval Tool on FAFSA. OR
Student has provided/will provide signed copy of 2017 1040, 1040A or 1040EZ tax form.
Student was not employed (in the US or any foreign country) and had no income earned from work in 2017.
The student was employed in the US in 2017 but did not le taxes. Was this a work-study position? Yes No
Student will provide copies of all 2017 IRS W-2 forms, if issued by employers.
VERIFICATION OF 2017 INCOME FOR PARENT(S)
One or both parents worked in a FOREIGN COUNTRY in 2017.
 Parent(s) will complete Foreign Income Supplement, even if no income was earned, and provide documentation.
(Oce use only: insert FAC19FID in CRI.)
One or both parents were employed in 2017 and parent(s) led US taxes.
 Parent(s) has used/will use IRS DATA Retrieval Tool on FAFSA. OR
 Parent(s) has provided/will provide signed copy of 2017 1040, 1040A or 1040EZ tax form.
One or both parents earned no income from work in 2017 (in the US or any foreign country).
Parent(s) will complete Non-Tax Filer form (unless ling jointly with spouse).
One or both parents were employed in the US in 2017 but did not le taxes. Was this a work-study position? Yes No
Parent(s) will provide copies of all 2017 IRS W-2 forms, if issued by employers.
D.NetWorthas of THE DATE FAFSA WAS COMPLETED
Please carefully read the notes on page 3 which explain the criteria for each asset. Enter the net worth of assets as of the date
FAFSA was completed. If you do not have any assets in that category, enter $0. If the net worth is negative, enter $0.
Student Parent(s)
Net Worth of Cash, Savings, and Checking Accounts
Net Worth of Investment*
Net Worth of Business/ Investment Farm**
2017 Filing
Requirements
for Most
Taxpayers
See IRS Publication 17
for detailed guidance or
if you are over 65.
IF your ling status is...
AND at the end of 2017
you were...
THEN le a return if your
gross income was at least...
Single Dependent under 24 $6,350
Single Independent Student under 65 $10,400
Married ling jointly under 65 (both spouses) $20,800
Married ling separately any age $ 4,050
Head of household under 65 $13,400
Qualifying widow(er) under 65 $16,750
Notes on Verication of
Income for Individuals with
Unusual Circumstances
An individual who is required to le a 2017
IRS income tax return and has been grant-
ed a ling extension by the IRS beyond the
automatic six-month extension for tax year
2017, 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 2017;
• A copy of the IRS’s approval of an exten-
sion beyond the automatic six-month ex-
tension for tax year 2017;
• Verication of Non-ling Letter (conrma-
tion that the tax return has not yet been
led) from the IRS or other relevant tax
authority dated on or after October 1, 2018;
• A copy of IRS Form W–2 for each source
of employment income received or an
equivalent document for tax year 2017 and,
• If self-employed, a signed statement cer-
tifying the amount of the individual’s Ad-
justed Gross Income and the U.S. income
tax paid for tax year 2017.
An individual who led an amended
IRS income tax return for tax year 2017
must provide:
• A 2017 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 income and tax informa-
tion required to be veried; and
• A signed copy of the 2017 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 identity
theft.
Investments include:
• real estate (do not include the home in
which you live);
• rental property (includes a unit within a
family home that has its own entrance,
kitchen, and bath rented to someone
other than a family member);
• trust funds;
• UGMA and UTMA accounts;
• money market funds;
• mutual funds;
• certicates of deposit;
• stocks;
• stock options;
• bonds;
• other securities;
• installment and land sale contracts
(including mortgages held);
• commodities, etc.
Investments also include:
• qualifed educational benefts or education
savings accounts (e.g., Coverdell savings
accounts;
• 529 college savings plans and the refund
value of 529 prepaid tuition plans). For
a student who does not report parental
information, the accounts owned by the
student (and/or the student’s spouse)
are reported as student investments in
question 42. For a student who must
report parental information, the accounts
are reported as parental investments in
question 91, including all accounts owned
by the student and all accounts owned
by the parents for any member of the
household.
• Money received, or paid on your behalf,
also includes distributions to you (the
student benefciary) from a 529 plan that
is owned by someone other than you or
your parents (such as your grandparents,
aunts, uncles, and non-custodial
parents).
Investments DO NOT include:
• the home you live in, the value of life
insurance;
• retirement plans (401[k] plans;
• pension funds;
• annuities;
• non-education IRAs, Keogh plans, etc.);
• cash, savings and checking accounts
already reported in questions 41 and 90;
• UGMA and UTMA accounts for which
you are the custodian, but not the
owner. Investment value means the
current balance or market value of these
investments as of today. Investment debt
means only those debts that are related
to the investments.
Business and/or investment farm
value includes:
• the market value of land, buildings,
machinery, equipment, inventory, etc.
Business and/or investment farm debt
means only those debts for which the
business or investment farm was used as
collateral.
Business value DOES NOT include:
• the value of a small business if your
family owns and controls more than 50
percent of the business and the business
has 100 or fewer full-time or full-time
equivalent employees. For small business
value, your family includes (1) persons
directly related to you, such as a parent,
sister or cousin, or (2) persons who are
or were related to you by marriage, such
as a spouse, stepparent or sister-in-law.
Investment farm value does not include
the value of a family farm that you (your
spouse and/or your parents) live on and
operate
Net worth means the current value, as of today, of investments, businesses, and/or
investment farms, minus debts related to those same investments, businesses, and/or
investment farms. When calculating net worth, use 0 for investments or properties with
a negative value.
Notes on Current Net Worth (section C)
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Completed 22 July 2020

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