OFFICE OF FINANCIAL AID
2019-2020 Verification Worksheet
Your Free Application for Federal Student Aid (FAFSA) was selected
for a “Verification” process which compares information from your
FAFSA with your (and your spouse’s, if you are married) 2017
Federal income tax information and/or other financial documents.
Based on this review, Purdue University Northwest may need to
make electronic corrections to your FAFSA information.
Verification must be completed by Sept. 30, 2020 or 120 days after
your last day of enrollment for 2019-2020, whichever is earlier.
Verification includes receipt of a valid and correct Institutional
Student Information Record (ISIR) with an official Expected Family
Contribution (EFC). Financial aid will not be disbursed until the
verification process is complete.
Federal Law requires Purdue University Northwest to review the requested
information under the financial program rule 34CFR, Part 668
What you should do
1. Complete, sign and submit this Verification Worksheet.
2. Submit your (and your spouse’s) 2017 IRS Tax Return
Transcript(s), if required, and any other requested documents
to the Office of Financial Aid. IRS Tax Return Transcripts may
be requested from the IRS on-line at www.irs.gov or by calling
3. If the student and/or spouse, filed or will file, an Amended 2017
IRS Tax Return, contact the Office of Financial Aid at Purdue
Note: Deadline for submitting verification information is September 1, 2019.
Eligibility for financial aid will not be determined until verification is complete.
SECTION 1: To be completed by all students.
A. Student Information
Last Name First MI PUID
Address (include apt. no.) Date of Birth (month/day/year)
City State ZIP code Phone Number (include area code)
E-Mail Address Cell Phone Number (include area code)
B. Family Information
List the people in your household, include:
• Yourself, and your spouse if you have one.
• Your children, if you will provide more than half of their support from July 1, 2019 through June 30, 2020, even if they
did not live with you.
• Other people if they now 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, 2019 through June 30, 2020.
Write the names of all household members in the space(s) below. Also write in the name of the college for any household
member who will be attending college at least half-time between July 1, 2019 through June 30, 2020 and will be enrolled in
a degree, diploma, or certificate program. If you require additional space, please attach a separate page.
Full Name Age Relationship College
Self Purdue University Northwest
2200 169th Street * Hammond, IN 46323
(219)) 989-2301 * FAX: (219) 989-2141
1401 S. U.S. Hwy. 421 * Westville, IN 46391
* FAX: (219) 785-5653