YubaCommunityCollegeDistrict
 FinancialAidOffices
20192020IndependentVerificationInstructionsV5
Yourfinancialaidapplicationwasselectedfor aprocesscalled“verification”bytheDepartmentofEducation.TheFinancialAid
Officeisrequiredbythefederalgovernmenttoverifytheinformationyouprovidedonyourfinancialaidapplication (FAFSA) is
correct. Your financial aid application cannot be processed until all requested information
is received. Any required
correctionsmaydelaytheprocessingofyourfinancialaidawards.Theinstructionsapplytothestudentandspouse(ifmarried).
WHATYOUNEEDTODO:
1.Complete(inink)allsectionsoftheIndependentAggregateVerificationGroupWorksheet,signanddateit.
2.SubmitallrequiredformsanddocumentstotheFinancialAidOfficeatthecampusyouareattendingassoonaspossible.
Theverificationprocesscantakeup
toseveralweekstocomplete.CheckyourYCCDstudentemail(@go.yccd.edu)frequently
becausewewillcontactyouthroughyourstudentemailifthereareproblemsorweneedadditionalinformationafter
wereviewyourfile.
3.Provideproofofincomeearnedorbenefitsreceivedin2017
forstudentandspouse,ifmarried.Refertothechartbelowto
determinewhichincomeisrequiredtobeverifiedandwhatdocumentationyoumustsubmittotheFinancialAidOffice.
FILEDORWILLFILEA2017FEDERALINCOMETAXRETURN SUBMITTHEFOLLOWINGDOCUMENTATION:
Ifyouandyourspouse(ifmarried)fileda2017IRSIncomeTax
Returnand
usedtheIRSDataRetrievalTooltotransferyour2017IRSincometax
returninformationintoyourFAFSAand
didnotmakeanychangestothetransferredinformation
Youarenotrequiredtosubmita2017FederalTax
ReturnTranscript
Note:Youmayberequiredtoprovideadditional
documentationifwehavereasontobelievetheincome
informationisinaccurate.
Ifyouandyourspouse(ifmarried)filedorwillfilea2017IRSIncome
TaxReturnand
usedtheIRSDataRetrievalTooltotransferyour2017IRSincometax
returninformationintoyourFAFSAandchangedanyofthefields
containingtransferredinformationor
didnotusetheIRSDataRetrievalTooltotransferyour2017IRS
incometaxreturninformationintoyourFAFSA
Youarerequiredtosubmita2017FederalTaxReturn
Transcript.See#4forinstructions.
Note:Duetonewfederalfinancialaidregulations,
photocopiesofIRSIncomeTaxReturnscannolongerbe
acceptedtoverifyincome.
Ifyouandyourspouse(ifmarried)filedseparate2017IRSIncome
TaxReturns
Youarerequiredtosubmita2017FederalTaxReturn
Transcriptforboththestudentandspouse.See#4for
instructions.
Note:Duetonewfederalfinancialaidregulations,
photocopiesofIRSIncomeTaxReturnsandoriginal1040
formscannolongerbeacceptedtoverifyincome.
Ifyouorspouse(ifmarried)filedanamendedIRSIncomeTax
Note:Anamendedreturnisoneyoufileifyoumadeamistakeon
youroriginalreturnandyouhavetoamendorcorrectit.
Ifyouoryourspouse(ifmarried)fileda2017IRSIncomeTaxReturn
andareVictimsofIRSTaxRelatedIdentityTheft
Note:MayobtainacopyoftheTRDBVtranscriptbycallingtheIRS’s
IdentityProtectionSpecializedUnitat18009084490
Youarerequiredtosubmitted2017IRSIncomeTaxReturn
Transcript,
and
Asignedcopyofthe2017IRSForm1040Xthatwasfiled
withtheIRSshowingthecorrections
ATaxReturnDataBaseView(TRDBV)transcriptmustbe
submittedfromtheIRS,and
AStatementsignedanddatedbytheirtaxfiler
indicatingthatyou
areavictimoftaxrelatedidentity
theftandtheIRSisaware
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
5307497999
WoodlandCommunityCollege
2300EastGibsonRoad
Woodland,CA95776
5306615725
LakeCounty Campus
15880DamRoadExtension
Clearlake,CA95422
7079957923
DIDNOTORWILLNOTFILEA2017FEDERALINCOMETAXRETURN
SUBMITTHEFOLLOWINGDOCUMENTATION:
Ifyouand/oryourspouse(ifmarried)workedin2017,butdidnotfile
a2017FederalIncomeTaxReturnand
arenotrequiredtofilea2017FederalIncomeTaxReturn
2017W2and1099Form(s)fromeachemployeror
governmentagency
VerificationofNonFiling(VONF)datedonorafter
October1,2018.
Ifyouand/oryourspouse(ifmarried)werenotemployedandhadno
incomeearnedfromworkin2017and
arenotrequiredtofilea2017FederalIncomeTaxReturn
2017WageandTaxStatement
VerificationofNonfiling(VONF)datedonorafter
October1,2018.
Note:SeeinstructionsbelowtoobtainaVONF
OTHER SUBMITTHEFOLLOWINGDOCUMENTATION:
Identity/StatementofEducationalPurpose
CompletetheIdentityandStatementofEducational
Purpose,and
ProvidegovernmentissuedvalidphotoIDcard
HighSchoolCompletionStatus
Provideproofofhighschoolcompletionstatus.
4.TaxfilerscanrequestanIRSTaxReturnTranscript,freeofcharge,fromtheIRSinoneofthreeways:
A. RequestanIRSTaxTranscriptorVerificationofNonFilingOnline(VONF)atwww.irs.gov
UnderTOOLS:Clickon“GetMyTaxRecordOnline
Taxpayermusthaveaccesstovalidemailaddress,
Atextenabledphone,(notpayasyougo)andthephonemustbeinthetaxpayer’sname
Certainfinancialaccountnumbers(suchasacreditcardnumber
and/oraccountnumberforahome
mortgageorcarloan).Thisverifiesidentityonlythecardwillnotbecharged.
TheIRSwillsendaconfirmationcodeviaemailortexttofinalizethe“GetTranscriptOnline”
registration.
Select“GetStarted”andproceedtoenterpersonalinformation
To
requestaTaxReturnTranscriptorVerificationofNonFiling(VONF)bemailedtoyou:
UnderTOOLS:Clickon“GetMyTaxRecord”Mail
Select“TaxReturnTranscript”
Enteryourpersonaldemographicsandincludetheaddressfromyour2017FederalTaxReturn.When
asked,Select“ReturnTranscript”fortaxyear2017DONOTselecttheAccountTranscript!OR
CompleteIRSForm4506Tavailableatwww.irs.govforaTaxReturnTranscriptorVONF
MailorFaxcompletedformtotheaddress/faxnumberlistedonform
B. OrderanIRSTaxReturnTranscriptbyphone‐CallIRSat18009089946
SelectOption2torequestaTaxReturnTranscriptandfollowthepromptstocompleteyourrequest
5.
TheFinancialAidOfficenolongermailsawardletters.Onceyourverificationiscompletedyourfinancialaidaward(s)will
beavailableonWebAdvisorthroughthePortalathttp://mycampus.yccd.edu/.Allawardsarecontingentuponavailable
fundingandyourmeetingallstudenteligibilityrequirementsforFederal,StateandInstitutionalfinancialaidprograms.
YCCDreservestherighttomodifyyourawardsatanytime.Arevisedawardletterwillbepostedifanawardismodified.
TheFinancialAidOfficereviewsyourenrollmentstatus,satisfactoryacademicprogress(SAP)andothereligibilitycriteriaand
willauthorizeapaymentifyouareeligible.Theamountslistedonyourfinancialaidawardletterreflecttheawardsforafull‐
timestudent.Theamountyoureceivemaybeless
becauseitisbasedonthenumberofunitsyouareactivelyenrolledin
whenthedisbursementsareprocessed.
Rev 9/25/17 Independent V5
20192020IndependentVerificationWorksheet
  AggregateGroupV5
A.STUDENTINFORMATION
____________________________________________________________ ___________________________________________
LastNameFirstName M.I. SocialSecurityNumber
____________________________________________________________ ___________________________________________
MailingAddress(includeapt.no.)DateofBirth
____________________________________________________________ ___________________________________________
CityState ZipCode PhoneNumber(IncludeAreaCode)
B.FAMILY/HOUSEHOLDINFORMATION(StudentandSpouse)
HouseholdMembers Age
Readinstructionsinitems1through4andcompletethetablebelow.
1.Listthepeoplewholiveinyourhousehold.Includethefollowing:
Yourself
Yourspouse,ifyouaremarried
Yourchildrenoryourspouse’schildrenifyouoryourspousewillprovide
morethan50%oftheirsupportfromJuly1,2019throughJune30,2020,
evenif
theydonotlivewithyou.
Otherdependentsiftheynowlivewithyou,andyouandyourspouseprovide
morethan50%oftheirsupportandwillcontinuetoprovidemorethan50%
oftheirsupportthroughJune30,2020.
2.Writethedateofbirthforeach
familymemberin
thechartbelow.
Relationship
3.Writetherelationshipofeachfamilymemberto
thestudentinthechartbelow.
College
4.Includethenameofthecollegeforanyhousehold
memberwhowillbeenrolledinadegreeor
certificateprogramatleasthalftimebetween
July1,2019andJune30,2020.
FullName(Print)
DateofBirth
Relationship
CollegeAttending
In201920
#ofUnits
EnrolledIn
Self
5.Whatisyourcurrenthousingstatus? Ilivewithmyparent(s) Iliveoffcampus
Ifmorespaceisrequired,attachaseparatepagewiththestudent’snameandIDnumberatthetop.
C. INCOMEINFORMATION(StudentandSpouse)
1.TAXRETURNNONFILERS
Page1REV3/14/17IndependentV5
Checktheboxthatappliestothestudentandspouseifmarried. Submitthefollowingrequireddocuments:
Student
Spouse
I/wewerenotemployedandhadnoincomeearnedfrom
workin2017andarenotrequiredtofilea2017Federal
IncomeTaxReturn.
2017WageandTaxStatement
VerificationofNonfiling(VONF)datedonor
afterOctober1,2018.
Note:SeeInstructionsabove
Student
Spouse
I/weworkedin2017,butdidnotfileandarenotrequired
tofilea2017FederalIncomeTaxReturn.
2017W2Form(s)
VerificationofNonFiling(VONF)datedonor
afterOctober1,2018
Office Use Only:
DATE Received:
StudentName(Print):___________________________________________StudentID#:_______________________________
2.TAXRETURNFILERS
Checktheboxthatappliestothestudentandspouse,ifmarried. Submitthefollowingrequireddocuments:
Student
Spouse
I/wefileda2017FederalIncomeTaxReturnandusedtheIRS
DataRetrievalTooltotransfermy/our2017IRSincometax
returninformationintothestudent’sFAFSA.Ididnotmake
anychangestothetransferredinformation.
Nofurtherdocumentationisrequiredifthe
importedinformation
wasnotchangedonthe
FAFSA.
Note:Wemayrequireyoutoprovideadditional
documentationifwehavereasontobelievethe
informationisinaccurate.
Student
Spouse
I/wefileda2017FederalIncomeTaxReturnanddidnotuse
theIRSDataRetrievalTooltotransfermy/our2017IRS
incometaxreturninformationintothestudent’sFAFSA.
2017FederalTaxReturnTranscript
Student
Spouse
Wefiledseparate2017FederalIncomeTaxReturns.
2017FederalTaxReturnTranscript(Student)
2017FederalTaxReturnTranscript(Spouse)
Student
Spouse
I/wefiledanamended2017FederalIncomeTaxReturn.
2017FederalTaxReturnTranscript
20171040XSignedCopy
Student
Spouse
Ifyouoryourspouse(ifmarried)fileda2017IRSIncomeTax
ReturnandareVictimsofIRSTaxRelatedIdentityTheft
ATaxReturnDataBaseView(TRDBV)
transcriptmustbesubmittedfromtheIRS,
andSignedStatement
3.VERIFICATIONOFINCOMEINFORMATIONTAXRETURNNONFILERSONLY
Listbelowthenameofthepersonwhoearnedtheincome,thenamesofallemployers,theamountearnedfromeachemployer
in2017,andwhetheranIRSW2Formisprovided.Providecopiesofall2017
IRSW2Form(s)issuedtoyoubyyouremployer(s).
ListeveryemployereveniftheemployerdidnotissueanIRSW2Form.
NameofPersonWhoEarned
theIncome(Print)
Employer’sName Total2017
AmountEarned
IRSW2Form
Provided?

YesNo

YesNo

YesNo

YesNo

YesNo

YesNo
D.IDENTITYANDSTATEMENTOFEDUCATIONALPURPOSE(Student)
PleasereadandcompletetheIdentityandStatementofEducationalPurposeonpage4or5 ofthisform.Youmustcompleteone
oftwooptions.Witheitheroption, youmustprovideacopyofa valid governmentissuedphotoidentificationcardwiththeform.
Thiscanincludebutisnot
limitedtoadriver’slicense,otherstateissuedID,orpassport.
Option1:YoucansigntheforminthepresenceofaFinancialAidstaffmember.
Option2:Allowsthestudenttosigntheformbeforeanotarypublic.
Page2REV9/25/17IndependentV5
StudentName(Print):___________________________________________StudentID#:_______________________________
E.HIGHSCHOOLCOMPLETIONSTATUS(Student)
Provideoneofthefollowingdocumentsthatindicateyourhighschoolcompletionstatuswhenthestudentwillbegincollegein
20192020.AstudentwhoisunabletoobtainthedocumentationlistedbelowmustcontacttheFinancialAidOffice.
HighSchoolDiploma
Acopyofthestudent’shighschooldiploma.
Acopyofthestudent’sfinalofficialhighschooltranscriptthatshowsthedatewhenthediplomawasawarded.
AcopyofDDForm214
RecognizedEquivalentofaHighSchoolDiploma
Acopyofthestudent’sGeneralEducationalDevelopment(GED)certificate.
AnofficialGEDtranscriptthatindicatesthestudentpassedtheexam.
AstatecertificateortranscriptthattheStaterecognizesastheequivalentofahighschooldiploma(HiSET,TASC,orotherstate
authorizedexamination).
Acopy
ofthe“secondaryschoolleavingcertificate”orothersimilardocumentforstudentswhocompletedsecondaryeducationina
foreigncountry.
Anacademictranscriptthatindicatesthestudentsuccessfullycompletedatleastatwoyearprogramthatisacceptableforfullcredit
towardabachelor’sdegree.
Homeschool
Forahomeschooledstudentfromastatewherestatelawrequiresthestudenttoobtainasecondaryschoolcompletioncredentialfor
homeschool(otherthanahighschooldiplomaoritsrecognizedequivalent),acopyofthatcredential.
Forahomeschooledstudentfromastatewherestatelawdoesnot
requirethestudenttoobtainasecondaryschoolcompletion
credentialforhomeschool(otherthanahighschooldiplomaoritsrecognizedequivalent)atranscriptorequivalent,signedbythe
student’sparentorguardian,thatliststhesecondaryschoolcoursesthestudentcompletedandincludesastatementthatthestudent
successfullycompletedasecondaryschooleducationinahomeschoolsetting.
F.CERTIFICATIONANDSIGNATURE(StudentandParent)

Eachpersonsigningthisworksheetcertifiesthatalltheinformation
providedistrueandcompletetothebestoftheirknowledge.Parent
signatureisrequired.
__________________________________________________________________________________________________________________
StudentSignatureDateSpouse’sSignature(optional)Date
FINANCIALAIDOFFICEUSEONLY  
DateAwarded/FATech:___________________________________________ISIR:_________________EFC:___________________________
Comments:

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WARNING:Ifyoupurposelygivefalseormisleadinginformationon
thisworksheet
,
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besentencedto
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YubaCommunityCollegeDistrict
 FinancialAidOffices
IdentityandStatementofEducationalPurpose
StudentName(Print):________________________________________________ StudentID#:__________________________________
AsrequiredbytheDepartmentofEducation,youmustcompleteeitheroption 1attheFinancialAidOfficeatthecampusyouattendoroption2
withaNotaryPublic.Witheitheroption,youmustprovideacopyofavalidgovernmentissuedphoto
identificationcardwiththisform.
A.OPTION#1
The student must appear in person at YUBA COLLEGE or WOODLAND COMMUNITY COLLEGE to verify his or her identity by presenting a valid
governmentissuedphoto identification (ID), such as, but not limited to, a driver’s license, other stateissued ID, orpassport. 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
officialattheinstitutionauthorizedtocollectthe student’sID.
Inaddition,thestudentmustsign,inthepresenceoftheinstitutionalofficial,thefollowingEnglishorSpanishstatement:
STATEMENTOFEDUCATIONALPURPOSE
IcertifythatI,______________________________________________________________,amtheindividualsigningthisStatementofEducational
(PrintStudent’sName)
PurposeandthatthefederalstudentfinancialassistanceImayreceivewillonlybeusedforeducationalpurposesandtopaythecostofattending
YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEfor20192020.
DECLARACIÓNDEPROPÓSITOEDUCATIVO
Certificoqueyo,___________________________________________________________,soyelindividuoquefirmaestaDeclaracióndeFinalidad
(ImprimirNombredelEstudiante)
Educativayquelaayudafinancierafederalestudiantilqueyopuedarecibir,sóloseráutilizada parafineseducativosyparapagarelcostodeasistir
aYUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEpara20192020.
B.CERTIFICATIONANDSIGNATURE
Eachpersonsigningthisworksheetcertifiesthatallthe
informationreportediscompleteandcorrect.
_____________________________________________________________________________________________________________________
StudentSignature/FirmadeEstudiante Date/FechaStudent’sIDNumber/NúmerodeIdentificacióndelEstudiante


FINANCIALAIDOFFICEUSEONLY:
_____________________________________________________________________________________________________________________
FinancialAidRepresentativeSignatureDateTypeofValidID
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
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
5307497999
WoodlandCommunityCollege
2300EastGibsonRoad
Woodland,CA95776
5306615725
LakeCounty Campus
15880DamRoadExtension
Clearlake,CA95422
7079957923
WARNING:Ifyoupurposelygivefalseormisleadinginformationon
thisworksheet
,
y
ouma
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befined
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besentencedto
j
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,
orboth.
YubaCommunityCollegeDistrict
 FinancialAidOffices

IdentityandStatementofEducationalPurpose
StudentName(Print):________________________________________________ StudentID#:__________________________________
A.OPTION#2
IfthestudentisunabletoappearinpersonatYUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEtoverifyhisorheridentity,thestudentmust
providethefollowing:
(a) Acopyofthevalidgovernmentissuedphotoidentification(ID)thatisacknowledgedinthenotarystatementbelow,suchasbutnot
limitedtoadriver’slicense,otherstateissuedID,orpassport;and
(b) TheoriginalnotarizedStatementofEducationalPurpose(inEngli shorSpanish)providedbelow.
STATEMENTOFEDUCATIONALPURPOSE
IcertifythatI,__________________________________________________________,amtheindividualsigningthisStatementofEducational
(PrintStudent’sName)
PurposeandthatthefederalstudentfinancialassistanceImayreceivewillonlybeusedforeducationalpurposesandtopaythecostofattending
YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEfor20192020.
DECLARACIÓNDEPROPÓSITOEDUCATIVO
Certificoqueyo,_______________________________________________________,soyelindividuoquefirmaestaDeclaracióndeFinalidad
(ImprimirNombredelEstudiante)
Educativayquelaayudafinancierafederalestudiantilqueyopuedarecibir,sóloseráutilizada parafineseducativosyparapagarelcostodeasistir
aYUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEpara20192020.
B.CERTIFICATIONANDSIGNATURE
Eachpersonsigningthisworksheetcertifiesthatallthe
informationreportediscompleteandcorrect.
___________________________________________________________________ ______________________________________________
Student Signature / Firma de Estudiante Date / Fecha Student’s ID Number / Número de Identificación del Estudiante

C.NOTARY’SCERTIFICATEOFACKNOWLEDGEMENT
Stateof_____________________________________City/Countyof__________________________________________________________
On________________________________________,beforeme,______________________________________________________,personally
(Date) (Notary’sName)
appeared,____________________________________________________,andprovedtomeonbasisofsatisfactoryevidenceofidentification
(Printednameofsigner)
_____________________________________________________,tobetheabovenamedpersonwhosignedtheforegoinginstrument.

(TypeofgovernmentissuedphotoIDprovided)
WITNESSmyhandandofficialseal 
(seal)________________________________________________________ 
 (NotarySignature)

Mycommissionexpireson___________________________________
(Date)
Page5Rev.9/25/17IndependentV5
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
5307497999
WoodlandCommunityCollege
2300EastGibsonRoad
Woodland,CA95776
5306615725
LakeCounty Campus
15880DamRoadExtension
Clearlake,CA95422
7079957923
WARNING:Ifyoupurposelygivefalseormisleadinginformationon
thisworksheet
,
y
ouma
y
befined
,
besentencedto
j
ail
,
orboth.
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