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INDEPENDENT VERIFICATION FORM
2018-2019
Financial Aid Office/Enrollment Services
452 South Anderson Road, Rock Hill, South Carolina 29730
Phone (803) 327-8008 Fax (803) 981-7278
All sections must be completed.
Student Name ________________________________________ CID ____________________
A. Number of Household Members
List below the people in the student’s household. Include:
The student.
The student’s spouse, if the student is married.
The student’s or spouse’s children if the student or spouse will provide more than half of the children’s
support from July 1, 2018 - June 30, 2019, even if the children do not live with the student.
Other people if they now live with the student and the student or spouse provides more than half of
the other people’s support and will continue to provide more than half of their support through June
30, 2019.
Full Name Age Relationship to Student
Self
B. Number in College
Include below information about any household member who 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, 2018 and June 30, 2019. Include the name of the college. 6OEFSHSBEVBUFPOMZ
Name of Student Name of College
York Technical College
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C. Verification of 2016 Income Information for Student (and/or spouse) Check ONE
box.
We used the IRS Data Retrieval Tool to import data into the FAFSA.
We have attached the tax return transcript for 2016 to this form.
We did not file a tax return for 2016
and did not have any income from working.
We did not file a tax return for 2016, but we have attached W2 forms.
F. CCertification and Signature
By signing below, you certify that all of the
information reported is complete and correct.
___________________________________________ ________________________
Student’s Signature (Required) Date
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to jail, or both.
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