YubaCommunityCollegeDistrict
 F
inancialAidOffices
20202021DependentVerificationInstructionsV4
Yourfinancialaidapplicationwasselectedforaprocesscalled“verification”bytheDepartmentofEducation.TheFinancialAidOffice
isrequiredbythefederalgovernmenttoverifytheinformationyouprovidedonyourfinancialaidapplication(FAFSA)iscorrect.Your
financialaidapplicationcannotbeprocesseduntilallrequestedinformation
isreceived.Anyrequiredcorrectionsmaydelaythe
processingofyourfinancialaidawards.Theinstructionsbelowapplytothestudentandparent(s).
WHATYOUNEEDTODO:
1.Complete(inink)allsectionsoftheDependentCustomVerificationGroupWorksheet,signanddateit.
2.SubmitallrequiredformsanddocumentstotheFinancialAidOfficeatthecampusyouareattendingassoonaspossible.
Theverificationprocesscantakeup
toseveralweekstocomplete.CheckyourYCCDstudentemail(@go.yccd.edu)frequently
becausewewillcontactyouthroughyourstudentemailifthereareproblemsorweneedadditionalinformationafterwe
reviewyourfile.
3.Refertothechartbelowtodeterminewhichitemsarerequired
tobeverifiedandwhatdocumentationyoumustsubmittothe
FinancialAidOffice.
ITEMSREQUIREDTOBEVERIFIED SUBMITTHEFOLLOWINGDOCUMENTATION
HighSchoolCompletionStatus
ProvideProofofHighSchoolCompletionStatusOR
DDForm214thatindicatesHighSchoolGraduateorEquivalent
Identity/StatementofEducationalPurpose
CompletetheIdentityandStatementofEducationalPurpose
ProvideagovernmentissuedphotoIDcard
4.TheFinancialAidOfficenolongermailsawardletters.Onceyourverificationiscompletedyourfinancialaidaward(s)will
beavailableonWebAdvisorthroughthePortalathttp://mycampus.yccd.edu/.Allawardsarecontingentuponavailable
fundingandyourmeetingallstudenteligibilityrequirementsforFederal,StateandInstitutionalfinancialaidprograms.
YCCDreservestherighttomodifyyourawardsatanytime.Arevisedawardletterwillbepostedifanawardismodified.
TheFinancialAidOfficereviewsyourenrollmentstatus,satisfactoryacademic
progress(SAP)andothereligibilitycriteriaand
willauthorizeapaymentifyouareeligible.Theamountslistedonyourfinancialaidawardletterreflecttheawardsforafull‐
timestudent.Theamountyoureceivemaybelessbecauseitisbasedonthenumberofunitsyou
areactivelyenrolledin
whenthedisbursementsareprocessed.
Rev.10/4/19
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
5307497999
WoodlandCommunityCollege
2300EastGibsonRoad
Woodland,CA95776
5306615725
Lake County Campus
15880DamRoadExtension
Clearlake,CA95422
7079957923
20202021DependentVerificationWorksheetCustomGroupV4

A.STUDENTINFORMATION
____________________________________________________________ ___________________________________________
LastNameFirstName M.I. SocialSecurityNumber
____________________________________________________________ ___________________________________________
MailingAddress(includeapt.no.)DateofBirth
____________________________________________________________ ___________________________________________
CityState ZipCode PhoneNumber(IncludeAreaCode)
B.HIGHSCHOOLCOMPLETIONSTATUS(Student)
Provideoneofthefollowingdocumentsthatindicateyourhighschoolcompletionstatuswhenthestudentwillbegincollegein
20202021.AstudentwhoisunabletoobtainthedocumentationlistedbelowmustcontacttheFinancialAidOffice.
HighSchoolDiploma
Acopyofthestudent’shighschooldiploma.
Acopyofthestudent’sfinalofficialhighschooltranscriptthatshowsthedatewhenthediplomawasawarded.
AcopyoftheDDForm214thatindicatesthestudentisahighschoolgraduateorequivalent
RecognizedEquivalentofaHighSchoolDiploma
Acopyofthestudent’sGeneralEducationalDevelopment(GED)certificate.
AnofficialGEDtranscriptthatindicatesthestudentpassedtheexam.
AstatecertificateortranscriptthattheStaterecognizesastheequivalentofahighschooldiploma(HiSET,TASC,orotherstateauthorized
examination).
Acopy
ofthe“secondaryschoolleavingcertificate”orothersimilardocumentforstudentswhocompletedsecondaryeducationina
foreigncountry.
Anacademictranscriptthatindicatesthestudentsuccessfullycompletedatleastatwoyearprogramthatisacceptableforfullcredit
towardabachelor’sdegree.
Homeschool
Forahomeschooledstudentfromastatewherestatelawrequiresthestudenttoobtainasecondaryschoolcompletioncredentialfor
homeschool(otherthanahighschooldiplomaoritsrecognizedequivalent),acopyofthatcredential.
Forahomeschooledstudentfromastatewherestatelawdoesnot
requirethestudenttoobtainasecondaryschoolcompletioncredential
forhomeschool(otherthanahighschooldiplomaoritsrecognizedequivalent)atranscriptorequivalent,signedbythestudent’sparent
orguardian,thatliststhesecondaryschoolcoursesthestudentcompletedandincludesastatementthatthestudentsuccessfully
completedasecondaryschooleducationinahomeschoolsetting.
E.IDENTITYANDSTATEMENTOFEDUCATIONALPURPOSE(Student)
PleasereadandcompletetheIdentityandStatementofEducationalPurposeonpage2or3ofthisform.Youmustcompleteoneof
twooptions.Witheitheroption,youmustprovideacopyofagovernmentissuedvalidphotoidentificationcardwiththeform.This
canincludebutisnot
limitedtoadriver’slicense,otherstateissuedID,orpassport.
Option1:YoucansigntheforminthepresenceofaFinancialAidstaffmember.
Option2:Allowsthestudenttosigntheformbeforeanotarypublic.
F.CERTIFICATIONANDSIGNATURE(StudentandParent)
Eachpersonsigningthisworksheet,certifiesthatalltheinformation
providedistrueandcompletetothebestoftheirknowledge.Parent
signatureisrequired.
____________________________________________________________________________________________________________________
StudentSignature  DateParentSignature
Date
Page1Rev10/4/19DependentV4
WARNING:Ifyoupurposelygivefalseormisleadinginformationon
thisworksheet
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Office Use Only:
DATE Received:
StudentName(Print):___________________________________________StudentID#:_______________________________
YubaCommunityCollegeDistrict
 FinancialAidOffices


IdentityandStatementofEducationalPurpose
StudentName(Print):________________________________________________ StudentID#:__________________________________
AsrequiredbytheDepartmentofEducation,youmustcomplete either option 1attheFinancialAid Office at the campusyouattendoroption 2
withaNotaryPublic.Witheitheroption,youmustprovideacopyofavalidgovernmentissuedphotoidentificationcardwiththisform.
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
governmentissued photo identification (ID), such as, but not limited to, a driver’s license, other stateissued ID, or passport. The institution will
maintainacopyofthestudent’sphotoIDthatisannotatedbytheinstitutionwiththedateitwasreceivedandreviewedandthenameoftheofficial
attheinstitutionauthorizedtocollectthestudent’sID.
Inaddition,thestudentmustsign,inthepresenceoftheinstitutionalofficial,thefollowingEnglishorSpanishstatement:
STATEMENTOFEDUCATIONALPURPOSE
IcertifythatI,______________________________________________________________,amtheindividualsigningthisStatementofEducational
(PrintStudent’sName)
PurposeandthatthefederalstudentfinancialassistanceImayreceivewillonlybeusedforeducationalpurposesandtopaythecostofattending
YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEfor20202021.
DECLARACIÓNDEPROPÓSITOEDUCATIVO
Certificoqueyo,___________________________________________________________,soyelindividuoquefirmaestaDeclaracióndeFinalidad
(ImprimirNombredelEstudiante)
Educativayquelaayudafinancierafederalestudiantilqueyopuedarecibir,sóloseráutilizadaparafineseducativosyparapagarelcostodeasistira
YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEpara20202021.
B.CERTIFICATIONANDSIGNATURE
Eachpersonsigningthisworksheetcertifiesthatallthe
informationreportediscompleteandcorrect.
___________________________________________________________________ ______________________________________________
StudentSignature/FirmadeEstudiante  Date/Fecha Student’sIDNumber/NúmerodeIdentificacióndelEstudiante

FINANCIALAIDOFFICEUSEONLY:
___________________________________________________________________ ______________________________________________
FinancialAidRepresentativeSignature Date TypeofValidID
Page2Rev10/4/19DependentV4
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.
StudentName(Print):___________________________________________StudentID#:_______________________________
YubaCommunityCollegeDistrict
 FinancialAidOffices

IdentityandStatementofEducationalPurpose
A.OPTION#2
Ifthestudentisunable toappearinpersonatYUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEtoverifyhisorheridentity,thestudentmust
providethefollowing:
(a) Acopyofthe validgovernmentissuedphotoidentification(ID)thatisacknowledgedinthenotarystatementbelow,suchasbutnot
limitedtoadriver’slicense,otherstateissuedID,orpassport;and
(b) TheoriginalnotarizedStatementofEducationalPurpose(inEnglishorSpanish)providedbelow.
STATEMENTOFEDUCATIONALPURPOSE
IcertifythatI,__________________________________________________________,amtheindividualsigningthisStatementofEducational
(PrintStudent’sName)
PurposeandthatthefederalstudentfinancialassistanceImayreceivewillonlybeusedforeducationalpurposesandtopaythecostofattending
YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEfor20202021.
DECLARACIÓNDEPROPÓSITOEDUCATIVO
Certificoqueyo,_______________________________________________________,soyelindividuoquefirmaestaDeclaracióndeFinalidad
(ImprimirNombredelEstudiante)
Educativayquelaayudafinancierafederalestudiantilqueyopuedarecibir,sóloseráutilizadaparafineseducativosyparapagarelcostodeasistira
YUBACOLLEGEorWOODLANDCOMMUNITYCOLLEGEpara20202021.
B.CERTIFICATIONANDSIGNATURE
Eachpersonsigningthisworksheetcertifiesthatallthe
informationreportediscompleteandcorrect.
___________________________________________________________________ ______________________________________________
StudentSignature/FirmadeEstudiante  Date/Fecha Student’sIDNumber/NúmerodeIdentificacióndelEstudiante
C.NOTARY’SCERTIFICATEOFACKNOWLEDGEMENT
Stateof_____________________________________City/Countyof__________________________________________________________
On________________________________________,beforeme,______________________________________________________,personally
(Date) (Notary’sName)
appeared,____________________________________________________,andprovedtomeonbasisofsatisfactoryevidenceofidentification
(Printednameofsigner)
_____________________________________________________,tobetheabovenamedpersonwhosignedtheforegoinginstrument.

(TypeofgovernmentissuedphotoIDprovided)
WITNESSmyhandandofficialseal 
(seal)________________________________________________________ 
Mycommissionexpireson___________________________________ (NotarySignature)
(Date)
Page3Rev10/4/19  DependentV4
YubaCollege
2088NorthBealeRoad
Marysville,CA95901
5307497999
Woodland CommunityCollege
2300EastGibsonRoad
Woodland,CA95776
5306615725
Lake County Campus
15880DamRoadExtension
Clearlake,CA95422
7079957923
FINANCIALAIDOFFICEUSEONLY:
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