Fillable Ggu 2019 2020 Dependent Worksheet V1 (Golden Gate University)

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Ggu 2019 2020 Dependent Worksheet V1 (Golden Gate University)

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  • 14 check-boxes
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2019-2020 Verification Worksheet
Dependent Student- Tracking Group V1
Your 2019–2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. Before awarding
Federal
Student Aid, you must confirm the information you and your parents reported on your FAFSA. We will compare your FAFSA with the
information on this worksheet and with any other required documents. If there are differences, your FAFSA information may need to be
corrected. You and at least one parent must complete and sign this worksheet, attach any required documents, and submit the form and other
required documents to the financial aid office. Additional information may be required to resolve conflicting information.
A. Dependent Student’s Information
Student’s Last Name Student’s First Name MI Student’s ID Number
Student’s Street Address (include apt. no.) Student’s Date of Birth
City State Zip Student’s Email Address
Student’s Phone Number Student’s Alternate or Cell Phone Number
B. Dependent Student’s Family information
Number of Household Members: List below the people in the parents’ household.
Include:
• The student.
• The parents (including a stepparent) even if the student doesn’t live with the parents.
• The parents’ other children if the parents will provide more than half of the children’s support from July 1, 2019, through June 30,
2020, or if the other children would be required to provide parental information if they were completing a FAFSA for 2019-2020.
Include children who meet either of these standards even if the children do not live with the parents.
• Other people if they now live with the parents and the parents provide more than half of the other people’s support and will
continue to provide more than half of their support through June 30, 2020.
Number in College: Please include in the space below information about any household member, excluding the parents, who is, or will be,
enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary educational institution any time between
July 1, 2019, and June 30, 2020, include the name of the college.
Full Name Age Relationship C
olle
ge
Will be Enrolled at
L
e
ast
Half Time (Yes or
No)
Missy Jones (example)
27
Sister
Central University
Yes
Note: We may require additional documentation if we have reason to believe that the information regarding the household members
enrolled in eligible postsecondary educational institutions is inaccurate.
C. Dependent Student’s Income Information to Be Verified
1. TAX RETURN FILERS
Instructions: Complete this section if the student filed or will file a 2017 IRS income tax return(s). 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 2017
income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed.
Check the box that applies:
The student has used the IRS DRT in FAFSA on the Web to transfer 2017 IRS income tax return information into the student’s FAFSA.
The student has not yet used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2017 IRS income tax return information
into the student’s FAFSA once the 2017 IRS income tax return has been filed.
5
Student Name___________________________________ Student ID#_______________
The student is unable or chooses not to use the IRS DRT in FAFSA on the Web, and instead will provide the school a 2017 IRS Tax Return
Transcript(s).
A 2017 IRS Tax Return Transcript may be obtained through:
•
Online Request – You can get your free transcripts immediately online. Go to www.IRS.gov, under the Tools heading on the IRS
homepage, click on “Get a Tax Transcript” and “Get Transcript ONLINE.” Make sure to request the “IRS Tax Return Transcript” and NOT the
“IRS Tax Account Transcript.”
•
Mail Request – Transcripts arrive in 5 -10 calendar days at the address IRS have on file. Go To www.IRS.gov, under Tools, click on Get
Transcript and click on “Get Transcript by MAIL.”
•
IRS2Go App- Make sure to request the “Return Transcript” NOT the “Account Transcript”
Apple Online Store at https://itunes.apple.com/us/app/irs2go/id414113282?mt=8
Google Play at https://play.google.com/store/apps/details?id=gov.irs
Use the Social Security Number (or the IRS individual taxpayer identification number) and the date of birth of the first person listed on the 2017 IRS
income tax return, and the address on file with the IRS (normally this will be the address used on the 2017 IRS income tax return).
Check here if a 2017 IRS Tax Return Transcript(s) is provided.
Check here if a 2017 IRS Tax Return Transcript(s) will be provided later.
2. TAX RETURN NONFILERS
Complete this section if the student will not file and is not required to file a 2017 income tax return with the IRS.
• Please note: For non-tax filers, a 2017 IRS Non-filing Confirmation is required. Please complete the 4506-T.
Go to
www.irs.gov/pub/irs-pdf/f4506t.pdf, complete the form and check box 7, sign, and fax the form to the IRS.
Check the box that applies:
The student was not employed and had no income earned from work in 2017.
The student was employed in 2017 and has listed below the names of all employers, the amount earned from each employer in 2017,
and whether an IRS W-2 form is provided. Provided copies of all 2017 IRS W-2 forms issued to the student by his/her employers. List every
employer even if they did not issue an IRS W-2 form.
If more space is needed, attach a separate page with the student’s name and Student’s ID Number at the top.
Employer’s
Na
me
2017 Amount Earned
IRS W-2
Attached?
$1,280
Yes
Note: We require you to provide documentation from the IRS that indicates a 2017 IRS income tax return was not filed with the IRS.
D. Parent’s Income
Information
to Be Verified
1. TAX RETURN FILERS
Important Note: The instructions below apply to each parent included in the household. Notify the financial aid office if the parents filed
separate IRS income tax returns for 2017 or had a change in marital status after the end of the 2017 tax year on December 31, 2017.
Instructions: Complete this section if the parents filed or will file a 2017 IRS income tax return(s). 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
2017 income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed.
Check the box that applies:
The parents have used the IRS DRT in FAFSA on the Web to transfer 2017 IRS income tax return information into the student’s FAFSA.
The parents have not yet used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2017 IRS income tax return information
into the student’s FAFSA once the 2017 IRS income tax return has been filed.
6
Student Name___________________________________ Student ID#_______________
The parents are unable or choose not to use the IRS DRT in FAFSA on the Web, and instead will provide the school a 2017 IRS Tax Return
Transcript(s).
A 2017 IRS Tax Return Transcript may be obtained through:
•
Online Request – You can get your free transcripts immediately online. Go to www.IRS.gov, under the Tools heading on the IRS
homepage, click on “Get a Tax Transcript” and “Get Transcript ONLINE.” Make sure to request the “IRS Tax Return Transcript” and NOT the
“IRS Tax Account Transcript.”
•
Mail Request – Transcripts arrive in 5 -10 calendar days at the address IRS have on file. Go To www.IRS.gov, under Tools, click on Get
Transcript and click on “Get Transcript by MAIL.”
•
IRS2Go App- Make sure to request the “Return Transcript” NOT the “Account Transcript”
Apple Online Store at https://itunes.apple.com/us/app/irs2go/id414113282?mt=8
Google Play at https://play.google.com/store/apps/details?id=gov.irs
Use the Social Security Number (or the IRS individual taxpayer identification number) and the date of birth of the first person listed on the 2017 IRS
income tax return, and the address on file with the IRS (normally this will be the address used on the 2017 IRS income tax return).
If the parents filed separate 2017 IRS income tax returns, 2017 IRS Tax Return Transcripts must be provided for each.
Check here if a 2017 IRS Tax Return Transcript(s) is provided.
Check here if a 2017 IRS Tax Return Transcript(s) will be provided later.
2. TAX RETURN NONFILERS
Complete this section if the student’s parent(s) will not file and is not required to file a 2017 income tax return with the IRS.
• Please note: For non-tax filers, a 2017 IRS Non-filing Confirmation is required. Please complete the 4506-T.
Go to
www.irs.gov/pub/irs-pdf/f4506t.pdf, complete the form and check box 7, sign, and fax the form to the IRS.
Check the box that applies:
Neither parent was employed, and neither had income earned from work in 2017.
One or both parents were employed in 2017 and have listed below the names of all employers, the amount earned from each
employer in 2017, and whether an IRS W-2 form is provided. Provide copies of all 2017 IRS W-2 forms issued to the parents by their
employers. List every employer even if they did not issue an IRS W-2 form.
If more space is needed, attach a separate page with the student’s name and Student’s ID Number at the top.
Employer’s Name 2017 Amount Earned For Whom? IRS W-2 Attached?
Pro Auto
$980
Father
Yes
Note: We require you to provide documentation from the IRS that indicates a 2017 IRS income tax return was not filed with the IRS.
E. Certification and Signatures
Each person signing this worksheet certifies that all of the information reported on it is complete and correct. WARNING: If you purposely give
false or misleading Information on this worksheet, you may be fined, be sentenced to jail, or both.
The student and one parent must sign and date.
Student’s Signature Date
Parent’s Signature Date
Do not mail this worksheet to the U.S. Department of Education. Submit this worksheet to the financial aid
administrator
at your
school.
You should make a copy
of this worksheet for your
records.
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2019-2020 INCOME/EXPENSE CERTIFICATION (GRANT RECIPIENT)
STUDENT INCOME (AND SPOUSE) 2017 INCOME INFORMATION
Please list all income and cash support that you received from January 2017 through December 2017. Include untaxed
earnings that are not reported on your federal income tax return (if you are required to file). If you are married, you MUST
list your spouse's income information.
SOURCE OF INCOME ANNUAL AMOUNT
WAGES
SPOUSE/PARTNER WAGES
UNTAXED INCOME
BENEFITS PROGRAM
FINANCIAL AID
PERSONAL BILLS PAID ON MY
BEHALF
VETERANS NONEDUCATIONAL
BENEFITS
TOTAL INCOME
STUDENT (AND SPOUSE) 2017 EXPENSE INFORMATION
Please list all of your expenses from January 2017 through December 2017. If you are married, you MUST list your
spouse's expense information.
MONTHLY AMOUNT ANNUAL AMOUNT
RENT/MORTGAGE
UTILITIES
FOOD
TRANSPORTATION
CLOTHING
ENTERTAINMENT
OTHER
TOTAL EXPENSES
I hereby certify that all the above information is true, complete and correct. I understand that by providing false
information, I may lose financial aid eligibility which may result in my owing GGU for whatever costs I may have
already incurred.
STUDENT SIGNATURE DATE
Golden Gate University Financial Aid Office Last Revision: 12/23/2018
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
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2019-2020 INCOME/EXPENSE CERTIFICATION (GRANT RECIPIENT)
Please select the appropriate box for the following questions:
a) Do you have a parent or guardian that was a member of the armed forces and died as a result of military service in
Iraq or Afghanistan after 9/11/2001?
Yes
No
* Declined to Answer
b) Were you less than 24 years of age or enrolled as a student at an institution of higher education at the time of your
parent/guardian's death?
Yes
No
* Declined to Answer
c) Student who is subject to involuntary civil commitment upon completion of a period of incarceration for a forcible or
non-forcible sexual offense is ineligible to receive a Pell Grant.
Does this apply to you?
Yes
No
* Declined to Answer
*Checking this box will make you ineligible to receive Pell or FSEOG Grants per federal regulations
As an eligible Pell Grant and/or FSEOG recipient, per federal regulations you must complete a review process called
"Verification" to receive your award. If you stated in your FAFSA that you have Zero income, reported very little
income to support yourself and/or your dependent(s), or were otherwise unable to complete on Page 1 of this form,
please explain below how you supported yourself and/or your dependent(s) in the past year:
I hereby certify that the information provided in this document is true and correct. I also understand that I may lose
my eligibility if I give false or misleading information.
Student Name Student Signature Date
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
To be completed by any person or persons who provided in-kind support to the student:
I hereby certify that the above statement is true and that I have provided in-kind support to the above student:
Name Signature Date
(Please attach a copy of the driver's license or signature ID of person who provided in-kind support)
Golden Gate University Financial Aid Office Last Revision: 12/23/2018
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Completed 22 July 2020

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