2020-2021 Verification Worksheet for Independent Student Form 1
Student ID Number: S
Student Name: Phone Number:
Form must be completed in blue or black ink. Failure to accurately complete this form may result in a
delay of processing or change of financial aid eligibility. Additional documentation may be requested.
Read instructions carefully before completing.
Section 1: Household Information
Student Information
List the people in your household, including:
Yourself (the student), and your spouse if you were married when you signed the FAFSA and;
Your dependent children, if you will provide more than half of their support * from July 1, 2020 through
June 30, 2021, even if they do not live with you, and;
Other people if they live with you, and you provide more than half of their support* and will continue
to provide more than half of their support from July 1, 2020 through June 30, 2021
Family Information
*Support includes money, gifts, loans, housing, food, clothes, car, medical/dental care, college tuition, etc.
Full Name
Relationship to
The name of the college attending from July 1, 2020
to June 30, 2021 and will be enrolled in at least half-time ,
in an eligible degree and/or certificate program.
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Student ID Number: S
Section 2: Income Information
If you and your spouse filed a 2018 Federal Income Tax Return, you must either give the Internal Revenue Service (IRS)
permission to transfer all2018 tax information directly to the FAFSA through the IRS Data Retrieval Tool, or submit a 2018
Federal Tax Return Transcript, or a signed copy of the 2018 Federal Tax Return.
To obtain an IRS Federal Tax Return Transcript, you may go to https://www.irs.gov/individuals/get-transcript and click
on “Get a Transcript Online” orGet a Transcript by Mail” or call 1-800-908-9946. Be sure to order the IRS Tax “Return
Transcript. If you and your spouse did not file 2018 taxes jointly, both you and your spouse should submit a Tax Return
If you and/or your spouse did not file a 2018 Federal Income Tax Return, you are required to submit a Statement of Non-
Filing and all 2018 W2s. To receive a 2018 Statement of Non-Filing, go to https://www.irs.gov/pub/irs-pdf/f4506t.pdf
complete form 4506-T with Box 7 checked. If you are unable to obtain the Statement of Non-Filing, please contact the
Financial Aid Office.
If you (the student) or your spouse are not able to locate your 2018 W2s, you can request to receive your Wage and
Income Statement by checking Box 8 on the 4506-T.
2018 Tax Filing Status: Only select one option for each individual Student Spouse
1. Has used or plans to use the IRS Data Retrieval Tool to transfer tax information
electronically on FAFSA. Or has plans to submit a copy of their 2018 IRS Federal Tax
Return Transcripts or signed 2018 IRS Federal Return.
2. Had no income, will not file, and was not required to file, a 2018 IRS Income Tax Return.
3. Has not filed, was not required to file, but had income earned from work in 2018 as listed
below and already has or plans to submit all 2018 W2’s. If this box is selected; wage
information must be completed below.
2018 Wage Information (Only Non-Filers)
Only complete wage information for each person who selected Option 3 in the previous chart.
Non-Tax Filer Name of Employer 2018 Income Earned
If more space is needed, attach a separate page with student’s name andstudent ID number.
By signing this document, I certify that the information is complete, true and accurate. I understand that
purposely providing false or misleading information could result in criminal prosecution, a prison sentence, and/or
a fine pursuant to U.S. Criminal Code and Colorado Criminal Code.
Student Signature:
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