Fillable Santa barbara city college 2019-2020 INDEPENDENT VERIFICATION WORKSHEET

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Santa barbara city college 2019-2020 INDEPENDENT VERIFICATION WORKSHEET

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721 Cliff Drive • Santa Barbara, California 93109-2394 • Phone (805) 730-5157 • Fax (805) 564-1893
2019-2020
INDEPENDENTVERIFICATIONWORKSHEET
Your application was selected for verification. This process requires our office to compare information from your financial aid application with copies of
you and your spouse's 2017 Federal Tax Return Transcripts or other financial documents. Federal and state regulations authorize the SBCC
Financial Aid Office to request this information before awarding student aid. If there are differences between your application and your financial
documents, we will submit these corrections electronically to the application processor.
Complete and sign this worksheet; do not leave any fields blank
Submitalldocumentationtoourofficeattheaddresslocated atthebottomofthepage
Check your pipeline account for supplemental requests
A. STUDENTINFORMATION
B. FAMILYINFORMATION
Listthepeopleinyour householdincluding:
• yourselfandyourspouse if you have one,and
• your children, if:
o you willprovidemorethanhalfoftheirsupportfromJuly1,2019throughJune30,2020,or
• otherpeopleonlyiftheynowlivewithyouand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thenameofthecollegeforanyhouseholdmember
whowillbe attendingcollegeatleasthalf-timebetweenJuly1,2019andJune30,2020,andwillbeenrolledina degree,diploma,or
certificate program.
Last Name (Print)
First Name M.I.
StudentID(K00 Number)
Pipeline Email Phone Number
1
Full Name
Age
Relationship To
Student
College and Federal Scho
o
l Code
Enrolled At Least
6 Units (Yes/No)
Example: Johnny Valentine 25 Spouse N/A
N/A
1.
Self Santa Barbara City College - 001285
2.
3.
4.
5.
6.
7.
8.
9.
10.
If you need more space, attach a separate page.
Financial Aid Office: www.sbcc.edu/financialaid/
721 Cliff Drive • Santa Barbara, California 93109-2394 • Phone (805) 965-0581 • Fax (805) 564-1893
C. STUDENT’S INCOME INFORMATION TO BE VERIFIED
If you did not file a 2017 Federal Tax Return, or if the income information reported on the financial aid application
appears low, please explain how living expenses were met in the space below.
Comments:
D. ADDITIONAL FINANCIAL INFORMATION
2
In 2017 or 2018, did anyone in your household receive:
Medicaid SupplementalSocialSecurityIncome(SSI) SupplementalNutritionAssistanceProgram(SNAP)
N/A
Temporary Assistance for Needy Families (TANF)
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
I Filed a 2017 Federal Tax Return
Federal 2017 Tax Information – select one option:
I have used the IRS Data Retrieval Tool on the FAFSA. (This tool is unavailable for the CA Dream Act
Application).
I have attached a copy of my 2017 Tax Return Transcript.
The Tax Return Transcript is available at www.irs.gov or by calling 1-800-908-9946.
Click here for further instructions. If you filed an amended tax return, a tax extension or have any
other unusual circumstance, please click here.
- OR -
I Was Not Required to File 2017 Federal Tax Return
I worked, but will not file
o I have attached a copy of my 2017 Verification of Non-Filing Letter from the IRS and have listed all sources
of income below.
o I have attached copies of all W-2 statements OR a Wage and Income Transcript for 2017.
o I do not have W-2 statements for 2017, as I was self-employed.
I did not work
o I have attached a 2017 Verification of Non-Filing Letter from the IRS and have listed all sources of income
below.
o Enter $0 or N/A if your parents' had no source of income.
Sources of Income and Employer Information for Non-filers Amount
1. Source/Employer’s Name: $
2. Source/Employer’s Name: $
721 Cliff Drive • Santa Barbara, California 93109-2394 • Phone (805) 965-0581 • Fax (805) 564-1893
E. ASSET INFORMATION (Enter $0 if not applicable.)
**Investments include: real estate (not including the home in which you live) rental property, trust funds, money market funds, mutual funds,
certificates of deposit, stock, stock options, bonds, etc.
***Do not include the value of a small business if your family owns and controls more than 50 percent of the business and the business has 100 or
fewer full-time employees.
Student’s Signature
Date
Report amounts as of the date your financial aid application was submitted.
STUDENT AND SPOUSE
Total cash, savings, and checking accounts $
Net worth of current investments** $
Net worth of businesses and/or investment farms*** $
3
I certify that
all the information on this form and any attachments and subsequent information provided to the SBCC Financial
Aid Office is true, complete and accurate to the best of my knowledge. I understand that false statements or mis
representations
will be cause for denial, reduction, withdrawal and/or repayment of financial aid and referral to appropriate administrators
under AP 500 Standards of Student Conduct.
F. SIGNATURES
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Santa barbara city college 2019-2020 INDEPENDENT VERIFICATION WORKSHEET

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Completed 7 March 2020

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