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SOUTHEASTERN COMMUNITY COLLEGE
FINANCIAL AID OFFICE
2020-2021 INDEPENDENT STUDENT VERIFICATION of HOUSEHOLD MEMBERS
Your 2020-2021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before
awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify that you provided correct
information, 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 must complete and sign this worksheet, attach any required documents, and submit the form
and other required documents to the SCC Financial Aid Office. SCC may ask for additional information. If you have questions about verification,
contact the Financial Aid Office as soon as possible so that your financial aid will not be delayed.
A. Independent Student’s Information
___________________________________________________________ ________________________________ ____________________
Student’s Last Name Student’s First Name Student’s M.I. Student’s ID or Social Security Number Student’s Date of Birth
Student’s Street Address (include apt. no.)
City and State Zip Code Student’s Email Address
Student’s Home Phone Number (include area code) Student’s Alternate or Cell Phone Number
B. As of today, what is your current marital status: ____ Single ____ Married/Remarried ____ Separated ____ Divorced/Widowed
Date of any marital status change: _____________
C. Independent Student’s Family Information
List below the people in your household. Include:
Your spouse, if you are married.
Your children, if any, if you will provide more than half of their support from July 1, 2020, through June 30, 2021, or if the child
would be required to provide your information if they were completing a FAFSA for 2020–2021. Include children who meet either of
these standards, even if they do 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 through June 30, 2021.
Include the name of the college for any household member who will be enrolled at least half time, in a degree, diploma, or certificate
program at a postsecondary educational institution any time between July 1, 2020, and June 30, 2021. If more space is needed, attach a
separate page with your name and Social Security Number at the top.
Full Name Age Relationship College Will be Enrolled at
Least Half Time
Self Southeastern Community College
D. Certification and Signature
I certify that all of the information reported on this worksheet is
complete and correct. The student must sign this worksheet.
Student’s Signature and Date
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.