Financial Aid Office
(708) 709-3735
Fax: (708) 709-3716
m:\stuserv\favaoffice\2014-15snapworksheet.docx
2014-15 SNAP Worksheet (V2)
Your application has been selected for review in a process called “verification.” The law requires specific
information from your Free Application for Federal Student Aid (FAFSA) be compared with the actual
information of you and your family. If there are differences, your FAFSA information may need to be
corrected. You must complete and sign this worksheet and submit it to the Financial Aid Office at the
college.
___________________________________________________ ________________________________
Last Name First Name MI Social Security Number
___________________________________________________ ________________________________
Address (include apartment number) Phone number (include area code)
___________________________________________________
City State Zip
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)/FOOD STAMPS
Did any member of your household listed above receive SNAP (Food Stamp Benefits) in 2013 or 2014?
Yes No
CERTIFICATIONS AND SIGNATURES
Each person signing this worksheet certifies that all of the information reported is complete and correct.
We also acknowledge that we have read and agree to comply with all verification policies as stated by
the college. 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 one
parent must sign:
___________________________________________ _______________________________________
Student Date Spouse/Parent (if applicable) Date
Note: If we have reason to believe that the information provided above is inaccurate, we may require
documentation from the agency that issued the SNAP benefits in 2013 or 2014.
Warning: If you purposely give false or misleading information on this worksheet, you may be fined,
sentenced to jail or both.
