STUDENT INFORMATION
FAMILY INFORMATION
CHILD SUPPORT PAID
Mail: Financial Aid Office
Eastern Wyoming College
3200 West C Street
Torrington, WY 82240
Fax: 307-532-8222
2014-2015
Independent V1 Worksheet
Standard Verification
Your application has been selected for review in a process called “Verification”. In this process, the information from your Free
Application for Federal Student Aid (FAFSA) will be compared with your and your spouse’s (if applicable) Federal IRS tax information
as well as other financial documents. If there are differences, your FAFSA information may need to be corrected. You and your spouse
(if applicable) must complete and sign this worksheet, attach all required documents and submit to the Financial Aid Office at EWC.
______________________________________________________________ __________________________________________
Last Name First Name M.I. EWC Student ID Number
______________________________________________________________ __________________________________________
Address (include apartment number) Social Security Number (last four digits)
______________________________________________________________ __________________________________________
City, ST, Zip Phone Number (include area code)
Fill in the information below about the people you and your spouse (if applicable) will support between July 1, 2014 and June 30, 2015.
INCLUDE YOURSELF, YOUR SPOUSE (if applicable), YOUR CHILDREN AND ANY OTHERS WHO RECEIVE MORE THAN
HALF OF THEIR SUPPORT FROM YOU. List the name of the college others will be attending if they are enrolled in a degree,
diploma, or certificate program for at least six credits per term between July 1, 2014 and June 30, 2015.
Full name of household member
Age
Relationship to student
College attending
Self EWC
Did anyone in your household PAY child support in 2013 for any children NOT listed above as a household member?
No Yes If “yes”, complete box below. If asked by my school, I will provide documentation of child support payment.
Name of person who
PAID child support
Name of person to whom
child support was paid
Name of child for whom
child support was paid
amount of child
Over
Revised 1_31_14
INCOME VERIFICATION
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)/FOOD STAMPS
CERTIFICATIONS AND SIGNATURES
STUDENT (and SPOUSE, if applicable) INCOME
INDEPENDENT
Did anyone in your household (listed above) receive benefits from the Supplemental Nutrition Assistance Program or SNAP (formerly
food stamps) in 2012 OR
2013?
No Yes Who received SNAP benefits (list all): __________________________________________________________________
If asked by my school, I will provide documentation of the receipt of SNAP benefits during 2012 and/or 2013.
The easiest way to verify income is to use the IRS Data Retrieval Tool when completing or updating your FAFSA on the federal web
site. If you did not use the IRS Data Retrieval Tool when completing or updating the FAFSA, you must provide an IRS Tax Return
Transcript. Due to changes in federal regulations, schools can no longer accept photocopies of tax returns. To request an IRS
Tax Return Transcript please visit www.irs.gov/Individuals/Get-Transcript
to download and print your transcript
immediately, or request the transcript be mailed to your address on record. Be sure to request a Tax Return Transcript, NOT an
Account Transcript. If you or your spouse (if applicable) did not and will not file a 2013 Federal tax return, please check the
appropriate box below. Please provide W-2 forms if you worked, but were not required to file a tax return.
I used the IRS Data Retrieval process to transfer my 2013 IRS income tax return information when completing/updating my
2014-2015 FAFSA.
My (and my spouse’s, if applicable) signed
2013 Federal IRS Tax Return Transcript(s) is (are) attached. (Foreign tax return
filers may submit signed photocopies.) See Income Verification section above for important details.
I was not employed and had no income earned from work in 2013.
I worked in 2013 but was not required to file a tax return. My 2013 W-2s are enclosed
. My earnings were: $______________
If you received income earned from the Federal Work-Study Program, need-based employment portions of fellowships and
assistantships, or a cooperative education program offered by a college in 2013, write in the type and amount you actually
included on your 2013 Federal tax return: Type: __________________________________________ $______________
My spouse was not employed and had no income earned from work in 2013.
My spouse worked in 2013 but was not required to file a tax return.
My spouse’s 2013 W-2s are enclosed
. My spouse’s earnings were: $_____________________________________________
By signing this worksheet, I/we certify that all of the information reported is complete and correct. I/we also acknowledge that I/we
have read and agree to comply with all verification policies as stated by EWC. Failure to submit information in a timely fashion
may result in the application being filed as inactive with no further consideration and no federal aid for the academic year. Student
and spouse (if applicable) must sign:
________________________________________________ _______________________________________________
Student’s signature Date Spouses signature Date
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.
Revised 1_31_14
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