Fill - Free fillable Form 5307497999: 20192020DependentVerificationInstructionsV4 (Woodland Community College) PDF form

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YubaCommunityCollegeDistrict

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 F

inancialAidOffices

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2019‐2020DependentVerificationInstructions–V4

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Yourfinancialaidapplicationwasselectedforaprocesscalled“verification”bytheDepartmentofEducation.TheFinancialAidOffice

isrequiredbythefederalgovernmenttoverifytheinformationyouprovidedonyourfinancialaidapplication(FAFSA)iscorrect.Your

financialaidapplicationcannotbeprocesseduntilallrequestedinformation

isreceived.Anyrequiredcorrectionsmaydelaythe

processingofyourfinancialaidawards.Theinstructionsbelowapplytothestudentandparent(s).

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WHATYOUNEEDTODO:

1.Complete(inink)allsectionsoftheDependentCustomVerificationGroupWorksheet,signanddateit.

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2.SubmitallrequiredformsanddocumentstotheFinancialAidOfficeatthecampusyouareattendingassoonaspossible.

Theverificationprocesscantakeup

toseveralweekstocomplete.CheckyourYCCDstudente‐mail(@go.yccd.edu)frequently

becausewewillcontactyouthroughyourstudente‐mailifthereareproblemsorweneedadditionalinformationafterwe

reviewyourfile.

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3.Refertothechartbelowtodeterminewhichitemsarerequired

tobeverifiedandwhatdocumentationyoumustsubmittothe

FinancialAidOffice.

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ITEMSREQUIREDTOBEVERIFIED SUBMITTHEFOLLOWINGDOCUMENTATION

 HighSchoolCompletionStatus

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 ProvideProofofHighSchoolCompletionStatusOR

 DDForm214thatindicatesHighSchoolGraduateorEquivalent

 Identity/StatementofEducationalPurpose

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 CompletetheIdentityandStatementofEducationalPurpose

 Provideagovernment‐issuedphotoIDcard

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4.TheFinancialAidOfficenolongermailsawardletters.Onceyourverificationiscompletedyourfinancialaidaward(s)will

beavailableonWebAdvisorthroughthePortalathttp://mycampus.yccd.edu/.Allawardsarecontingentuponavailable

fundingandyourmeetingallstudenteligibilityrequirementsforFederal,StateandInstitutionalfinancialaidprograms.

YCCDreservestherighttomodifyyourawardsatanytime.Arevisedawardletterwillbepostedifanawardismodified.

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TheFinancialAidOfficereviewsyourenrollmentstatus,satisfactoryacademic

progress(SAP)andothereligibilitycriteriaand

willauthorizeapaymentifyouareeligible.Theamountslistedonyourfinancialaidawardletterreflecttheawardsforafull‐

timestudent.Theamountyoureceivemaybelessbecauseitisbasedonthenumberofunitsyou

areactivelyenrolledin

whenthedisbursementsareprocessed.

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Rev.3/14/17

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YubaCollege

2088NorthBealeRoad

Marysville,CA95901

530‐749‐7999

WoodlandCommunityCollege

2300EastGibsonRoad

Woodland,CA95776

530‐661‐5725

Lake County Campus

15880DamRoadExtension

Clearlake,CA95422

707‐995‐7923

2019‐2020DependentVerificationWorksheetCustomGroup–V4

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A.STUDENTINFORMATION

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____________________________________________________________ ___________________________________________

LastNameFirstName M.I. SocialSecurityNumber

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____________________________________________________________ ___________________________________________

MailingAddress(includeapt.no.)DateofBirth

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____________________________________________________________ ___________________________________________

CityState  ZipCode PhoneNumber(IncludeAreaCode)

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B.HIGHSCHOOLCOMPLETIONSTATUS(Student)

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Provideoneofthefollowingdocumentsthatindicateyourhighschoolcompletionstatuswhenthestudentwillbegincollegein

2019‐2020.AstudentwhoisunabletoobtainthedocumentationlistedbelowmustcontacttheFinancialAidOffice.

HighSchoolDiploma

 Acopyofthestudent’shighschooldiploma.

 Acopyofthestudent’sfinalofficialhighschooltranscriptthatshowsthedatewhenthediplomawasawarded.

 AcopyoftheDDForm214thatindicatesthestudentisahighschoolgraduateorequivalent

RecognizedEquivalentofaHighSchoolDiploma

 Acopyofthestudent’sGeneralEducationalDevelopment(GED)certificate.

 AnofficialGEDtranscriptthatindicatesthestudentpassedtheexam.

 AstatecertificateortranscriptthattheStaterecognizesastheequivalentofahighschooldiploma(HiSET,TASC,orotherstate‐authorized

examination).

 Acopy

ofthe“secondaryschoolleavingcertificate”orothersimilardocumentforstudentswhocompletedsecondaryeducationina

foreigncountry.

 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.

Homeschool

 Forahomeschooledstudentfromastatewherestatelawrequiresthestudenttoobtainasecondaryschoolcompletioncredentialfor

homeschool(otherthanahighschooldiplomaoritsrecognizedequivalent),acopyofthatcredential.

 Forahomeschooledstudentfromastatewherestatelawdoesnot

requirethestudenttoobtainasecondaryschoolcompletioncredential

forhomeschool(otherthanahighschooldiplomaoritsrecognizedequivalent)atranscriptor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.

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E.IDENTITYANDSTATEMENTOFEDUCATIONALPURPOSE(Student)

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PleasereadandcompletetheIdentityandStatementofEducationalPurposeonpage2or3ofthisform.Youmustcompleteoneof

twooptions.Witheitheroption,youmustprovideacopyofagovernment‐issuedvalidphotoidentificationcardwiththeform.This

canincludebutisnot

limitedtoadriver’slicense,otherstate‐issuedID,orpassport.

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 Option1:YoucansigntheforminthepresenceofaFinancialAidstaffmember.

 Option2:Allowsthestudenttosigntheformbeforeanotarypublic.

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F.CERTIFICATIONANDSIGNATURE(StudentandParent)

Eachpersonsigningthisworksheet,certifiesthatalltheinformation

providedistrueandcompletetothebestoftheirknowledge.Parent

signatureisrequired.

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____________________________________________________________________________________________________________________

StudentSignature  DateParentSignature

   Date

Page1Rev9/14/17DependentV4

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WARNING:Ifyoupurposelygivefalseormisleadinginformationon

thisworksheet

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ouma

befined

besentencedto

ail

orboth.

Office Use Only:

DATE Received:

StudentName(Print):___________________________________________StudentID#:_______________________________

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YubaCommunityCollegeDistrict

 FinancialAidOffices

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 

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



IdentityandStatementofEducationalPurpose

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StudentName(Print):________________________________________________ StudentID#:__________________________________

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AsrequiredbytheDepartmentofEducation,youmustcomplete either option 1attheFinancialAid Office at the campusyouattendoroption 2

withaNotaryPublic.Witheitheroption,youmustprovideacopyofavalidgovernment‐issuedphotoidentificationcardwiththisform.

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A.OPTION#1

The student must appear in person  at YUBA COLLEGE or WOODLAND COMMUNITY COLLEGE to verify his or her identity by presenting valid

government‐issued photo identification (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official

attheinstitutionauthorizedtocollectthestudent’sID.

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Inaddition,thestudentmustsign,inthepresenceoftheinstitutionalofficial,thefollowingEnglishorSpanishstatement:



STATEMENTOFEDUCATIONALPURPOSE

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IcertifythatI,______________________________________________________________,amtheindividualsigningthisStatementofEducational

(PrintStudent’sName)

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

YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEfor2019‐2020.



DECLARACIÓNDEPROPÓSITOEDUCATIVO



Certificoqueyo,___________________________________________________________,soyelindividuoquefirmaestaDeclaracióndeFinalidad

(ImprimirNombredelEstudiante)

Educativayquelaayudafinancierafederalestudiantilqueyopuedarecibir,sóloseráutilizadaparafineseducativosyparapagarelcostodeasistira

YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEpara2019‐2020.



B.CERTIFICATIONANDSIGNATURE



Eachpersonsigningthisworksheetcertifiesthatallthe

informationreportediscompleteandcorrect.



___________________________________________________________________ ______________________________________________

StudentSignature/FirmadeEstudiante   Date/Fecha Student’sIDNumber/NúmerodeIdentificacióndelEstudiante







FINANCIALAIDOFFICEUSEONLY:



___________________________________________________________________ ______________________________________________

FinancialAidRepresentativeSignature   Date TypeofValidID



Page2Rev9/14/17DependentV4



YubaCollege

2088NorthBealeRoad

Marysville,CA95901

530‐749‐7999

WoodlandCommunityCollege

2300EastGibsonRoad

Woodland,CA95776

530‐661‐5725

LakeCounty Campus

15880DamRoadExtension

Clearlake,CA95422

707‐995‐7923

WARNING:Ifyoupurposelygivefalseormisleadinginformationon

thisworksheet



ouma

befined

besentencedto

ail

orboth.

StudentName(Print):___________________________________________StudentID#:_______________________________



YubaCommunityCollegeDistrict

 FinancialAidOffices



 



IdentityandStatementofEducationalPurpose

A.OPTION#2

Ifthestudentisunable toappearinpersonatYUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEtoverifyhisorheridentity,thestudentmust

providethefollowing:

(a) 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

(b) TheoriginalnotarizedStatementofEducationalPurpose(inEnglishorSpanish)providedbelow.



STATEMENTOFEDUCATIONALPURPOSE



IcertifythatI,__________________________________________________________,amtheindividualsigningthis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

YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEfor2019‐2020.



DECLARACIÓNDEPROPÓSITOEDUCATIVO



Certificoqueyo,_______________________________________________________,soyelindividuoquefirmaestaDeclaracióndeFinalidad

YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEpara2019‐2020.

B.CERTIFICATIONANDSIGNATURE

Eachpersonsigningthisworksheetcertifiesthatallthe

informationreportediscompleteandcorrect.



___________________________________________________________________ ______________________________________________

StudentSignature/FirmadeEstudiante   Date/Fecha Student’sIDNumber/NúmerodeIdentificacióndelEstudiante

C.NOTARY’SCERTIFICATEOFACKNOWLEDGEMENT

Stateof_____________________________________City/Countyof__________________________________________________________

On________________________________________,beforeme,______________________________________________________,personally

(Date) (Notary’sName)

appeared,____________________________________________________,andprovedtomeonbasisofsatisfactoryevidenceofidentification

(Printednameofsigner)

_____________________________________________________,tobetheabove‐namedpersonwhosignedtheforegoinginstrument.



(Typeofgovernment‐issuedphotoIDprovided)

WITNESSmyhandandofficialseal  

(seal)________________________________________________________ 

Mycommissionexpireson___________________________________   (NotarySignature)

(Date)

Page3Rev9/14/17   DependentV4

YubaCollege

2088NorthBealeRoad

Marysville,CA95901

530‐749‐7999

WoodlandCommunityCollege

2300EastGibsonRoad

Woodland,CA95776

530‐661‐5725

Lake County Campus

15880DamRoadExtension

Clearlake,CA95422

707‐995‐7923

FINANCIALAIDOFFICEUSEONLY:

DateAwarded/FATech:_________________________ISIR:__________EFC:__________⃝IdentityResultsReportedinFAAAcess

Comments:



WARNING:Ifyoupurposelygivefalseormisleadinginformationon

thisworksheet



ouma

befined

besentencedto

ail

orboth.

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NAME

Form 5307497999: 20192020DependentVerificationInstructionsV4 (Woodland Community College)

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