* This form must be submitted by the priority deadline to ensure a determination of eligibility before the Fee Due Date. Students may still apply
for aid after the priority deadlines, but EFSC cannot guarantee that late submissions will be notified of aid eligibility prior to the Fee Due Date.
04/17/20
21V5I
FA Verification
20
20-21 Verification Independent Student Form
V5 Aggregate Verification Group
Your 20202021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification.
About 30% of all FAFSA filers are selected for verification, which requires the school to collect documentation to review
the accuracy of FAFSA information. EFSC cannot award federal financial aid until this worksheet has been processed.
Priority Deadlines*: Fall 202007/23/20 | Spring 2021 – 11/30/20 | Summer 2021 – 04/22/21
THIS DOCUMENT MUST BE ORIGINAL NO PHOTOCOPIES OR SCANS ACCEPTED
A. Student Information
B#
Last Name First Name M.I. Student ID
B. Household Information
List below the people in your household. Include only:
Yourself.
Your spouse, if you are married.
Your children or spouse’s children, if any, if you or your spouse will provide more than half of the children’s
support from July 1, 2020, through June 30, 2021, even if the child does not live with you.
Other people if they now live with you and you 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, 2021.
If you list below any dependents between the ages of 24 and 64, you must also submit the 2020-
21
H
ousehold Dependents Form
.
Full Name
Age
Relationship
College
(Enter only if household member will
be attending at least ½ time; Do not
include dual-enrolled high school
students)
Will be
Enrolled at
Least ½ Time?
(Yes or No)
Self Eastern Florida State College
If more space is needed, submit a separate page with your name and B number. EFSC may require additional
documentation if we have reason to believe the information regarding the household members is incomplete or
inaccurate.
EFSC Office of Financial Aid
2
C. Student Income Information You must check only 1 box below.
NOTE: The instructions below apply to you and your spouse if you are married. Notify the Office of Financial Aid if
you had a change in marital status after December 31, 2018.
I filed a 2018 IRS tax return. Go to Section #1 below.
I did not and will not file a 2018 IRS tax return. Go to Section #2 on page 3.
I was granted a tax extension, filed an amended return, was a victim of IRS tax-related identify theft, or filed a
non-IRS income tax return for 2018. Go to Section #3 on page 4.
1. STUDENT TAX RETURN FILERS (IRS FORM 1040)
The best way to verify income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the
Web at FAFSA.gov. In most cases, no further documentation is needed to verify 2018 income information
that was transferred into your FAFSA using the IRS DRT if that information is not changed by the FAFSA filer.
Use of the IRS DRT is strongly recommended.
Check the box that applies:
I have used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2018 IRS income tax return
information into my FAFSA.
I have not yet used the IRS Data Retrieval Tool in the FAFSA, but will use the tool to transfer 2018 IRS
income tax return information into my FAFSA. Verification cannot be completed until the IRS
information has been transferred into the FAFSA.
I am unable or choose not to use the IRS Data Retrieval Tool in the FAFSA. I will submit to EFSC a 2018
IRS tax return transcript or a signed copy of the 2018 IRS Form 1040 I filed with the IRS. You must
check one box below.
My 2018 IRS tax return transcript is attached to this worksheet.
My 2018 IRS tax return transcript will be submitted to EFSC later. Verification cannot be
completed until the IRS tax return transcript has been submitted to EFSC.
My signed copy of the 2018 IRS Form 1040 and applicable schedules I filed with the IRS is
attached to this worksheet.
My signed copy of the 2018 IRS tax form 1040 and applicable schedules I filed with the IRS will be
submitted to EFSC later. Eligibility for aid cannot be determined until one of the IRS tax
documents is received.
A 2018 IRS Tax Return Transcript may be obtained through:
Get Transcript ONLINE
Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript Online.”
To use the new Get Transcript Online tool, the user must have (1) access to a valid email address,
(2
) a
text-enabled mobile phone (pay-as-you-go plans cannot be used) in the user’s name, and (3)
specific financial account numbers (such as a credit card number or an account number for a
home mortgage or auto loan).
The transcript displays online upon successful completion of the
I
RS’s two-step
authentication.
Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Get Transcript by MAIL
Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript by Mail.”
Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Paper Request Form
Complete IRS Form 4506-EZ and mail or fax to the IRS.
Do NOT request to have your transcript mailed directly to EFSC.
Please allow a minimum of 5-10 days to receive the transcript.
Go to Section D on page 5.
EFSC Office of Financial Aid
3
2. STUDENT TAX RETURN NONFILERS
The instructions and certifications below apply to you and your spouse if you are married. Complete this
section if you (and your spouse, if married) will not file and are not required to file a 2018 income tax return
with the IRS.
Check the box that applies:
I (and my spouse, if married) was not employed and had no income earned from work in 2018.
I (and/or my spouse, if married) was employed in 2018 and have listed below the names of all
employers, the amount earned from each employer in 2018, and whether an IRS W-2 form is attached.
You are required to submit a copy of each W-2 that was issued. List every employer even if they did not
issue an IRS W-2 form.
IRS W-2 Issued
by Employer
IRS W-2
Attached
2018 Amount Earned
Yes(example)
Yes(example)
$2,000.00(example)
Total Amount of Income Earned From Work
$
You (and your spouse) MUST submit an IRS Verification of Non-filing Letter. This is a new federal
requirement for 2020-21 and applies even if your parents earned zero income in 2018.
My 2018 IRS Verification of Non-filing Letter(s) is/are attached to this worksheet.
My 2018IRS Verification of Non-filing Letter(s) will be submitted to EFSC later.
Verification cannot be completed until the IRS tax return transcript has been submitted to EFSC.
A 2018 IRS Verification of Non-filing Letter may be obtained through the following methods.
NOTE: if you (or your spouse) have NEVER filed a tax return, you MUST use the Paper Request Form.
Get Transcript ONLINE
Go to www.irs.gov, click under the Tools heading, click "Get Your Tax Record.”
Click “Get Transcript Online.”
Make sure to request the “Verification of Non-Filing Letter.”
Get Transcript by MAIL
Go to www.irs.gov, click under the Tools heading, click "Get Your Tax Record.”
Click “Get Transcript by Mail.”
Make sure to request the “Verification of Non-Filing Letter.”
Paper Request Form
Complete IRS Form 4506-T and mail or fax to the IRS
Do NOT request to have your Verification of Non-Filing mailed directly to EFSC.
Please allow a minimum of 5-10 days to receive the Verification of Non-Filing.
Go to Section D on page 5.
EFSC Office of Financial Aid
4
3. STUDENT TAX FILERS WITH UNUSUAL CIRCUMSTANCES
If you are a tax filer with unusual circumstances for 2018, indicate below and submit all required documents
listed. Verification cannot be completed until all documents are submitted. Check the box that applies:
I was granted a filing extension by the IRS.
If you are required to file a 2018 IRS income tax return and have been granted a filing extension by the
IRS you must provide:
A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income
Tax Return,’’ that was filed with the IRS for tax year 2018; AND
A copy of the IRS's approval of an extension beyond the automatic six-month extension; AND
Verification of Non-filing Letter (confirmation that the tax return has not yet been filed) from the IRS
or other relevant tax authority dated on or after October 1, 2019; AND
A copy of IRS Form W–2 for each source of employment income received for tax year 2018 and, if
self-employed, a signed statement certifying the amount of your Adjusted Gross Income (AGI) and
the U.S. income tax paid for tax year 2018.
I filed an amended IRS income tax return (1040X).
If you filed an amended IRS income tax return for tax year 2018 you must provide:
A 2018 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
information required to be verified AND
A signed copy of the 2018 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was
filed with the IRS.
I am a victim of IRS tax-related identity theft.
If you were a victim of IRS tax-related identity theft you must provide:
A Tax Return DataBase View (TRDBV) transcript obtained from the IRS by calling the Identify
Protection Specialized Unit (IPSU) at 1-800-908-4490, or any other IRS tax transcript(s) that includes
all of the income and tax information required to be verified AND
A statement signed and dated by you indicating that you were a victim of IRS tax-related identity
theft and that the IRS is aware of the tax-related identity theft.
I filed a non-IRS income tax return.
A tax filer who filed an income tax return with Guam, the Commonwealth of the Northern Mariana
Islands, the Commonwealth of Puerto Rico and the U.S. Virgin Islands may provide a signed copy of
his or her income tax return that was filed with the relevant tax authority. However, if we question
the accuracy of the information on the signed copy of the income tax return, the tax filer must
provide us with a copy of the tax account information issued by the relevant tax authority before
verification can be completed.
A tax filer who filed an income tax return with the tax authority for American Samoa must provide a
copy of his or her tax account information.
A tax filer who filed an income tax return with tax authorities not mentioned above, i.e. a foreign tax
authority, and who indicates that he or she is unable to obtain the tax account information free of
charge, must provide documentation that the tax authority charges a fee to obtain that information,
along with a signed copy of his or her income tax return that was filed with the relevant tax
authority.
Go to Section D on page 5.
EFSC Office of Financial Aid
5
D. High School Completion Status
Please indicate your high school completion status when you begin college in 20202021:
I received or will have received a high school diploma.
I completed or will have completed secondary education in a foreign country and have a copy of the
“secondary school leaving certificate” or other similar document.
I have or will have passed a state authorized examination (GED test, HiSET, TASC, or other State-authorized
examination).
I completed or will have completed at least a two-year program that is acceptable for full credit towards a
bachelor’s degree.
I was homeschooled.
EFSC Office of Financial Aid
6
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 financial assistance I may receive will only be used
for educational purposes and to pay the cost of attending Eastern Florida State College for 2020-2021.
________________________________________ _______________
(Student’s Signature) (Date)
_________________________________________
(Student’s ID Number)
Notary’s Certificate of Acknowledgement
State of ______________________________________________
City/County of _________________________________________
On ________________________, before me, _________________________________________, personally appeared,
(Date) (Notary’s name)
_______________________________________, and proved to me on the basis of satisfactory evidence of identification
(Printed name of signer)
________________________________________ to be the above-named person who signed the foregoing instrument.
(Type of unexpired government-issued photo ID provided)
WI
TNESS my hand and official seal
________________________________________
(Notary’s Signature)
My commission expires on _________________________
(seal) (Date)
E. Identity and Statement of Educational Purpose To Be Signed With Notary
You must submit to EFSC:
A copy of the valid government-issued photo identification (ID) that is acknowledged in the notary
statement below, such as but not limited to a driver’s license, other state-issued ID, or passport;
AND
The original notarized Statement of Educational Purpose provided below.
EFSC Office of Financial Aid
7
F. Certification and Signature
By signi
ng below I certify that all of the information reported is
complete and correct.
Student’s Original Signature (cannot be signed electronically) Date
Eastern Florida State College
Office of Financial Aid
Building 2, Room 209
1519 Clearlake Road
Cocoa, FL 32922
QUESTIONS?
Financial Aid Specialists are available by phone at 321-433-7339 and via e-mail at finaid@easternflorida.edu.
Eastern Florida State College is committed to equal access/equal opportunity in its programs, activities, and employment.
For additional information, visit Eastern Florida State College: easternflorida.edu/go/equity.
WARNING: If you purposely give false
or misleading information, you may
be fined, sent to prison, or both.
G. Document Submission
You must submit via mail. This document MUST be original and cannot be e-mailed or uploaded.
1. BY MAIL
Mail your documentation to:
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