Student's Name:
Southeastern Louisiana University
Verification of Students Marital Status
Office of Financial Aid
SLU 10768
Hammond, LA 70402
Phone: 985-549-2244
Fax: 985-549-5077
University ID: W
INSTRUCTIONS TO STUDENTS: You are completing this form to verify your marital status as of the date the
FAFSA was filed. You are certifying this information to be true and correct.
(Students Name)
, certify that I am/was
(Married / Remarried, Never Married, Divorced / Separated, Widowed)
As of today, my marital status is
I/We reside at
(Physical Address - NO P.O. Box)
as of the date student's FAFSA was filed.
(Married / Remarried, Never Married, Divorced / Separated, Widowed)
If married, the name of my spouse is
The date we were married or began living together is
(Physical Address - NO P.O. Box)
If separated/divorced, the date of separation/divorce was .
My spouse resides at
The date of birth for my spouse is
Did you file 2017 taxes with your spouse?
If yes, please submit all W-2's for the 2017 tax year.
If separated, you must provide documentation of two separate addresses.
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Yes No
Please read, sign and date.
By signing this form you agree, if asked, to provide information that will verify the accuracy of this completed
form. This information may include your U.S. or state income tax forms, divorce decree, utility bills, etc. Also,
you certify that you understand that the Secretary of Education has the authority to verify information
reported on this form with the Internal Revenue Service and other federal agencies. If you purposely give
false or misleading information, you may be fined $20,000, sent to prison, or both.
Student's Signature: ____________________________________________ Date: _____________________________
FAA Comments :
University ID (or Social Security Number)
Full Name Age
to Student
Enrolled at Least Half-
Time (Yes or No)
Southeastern LA Univ.
Student's Family Information
List below the people in your household. Include:
Yourself and your spouse if you are married. (Do not include your spouse if you are separated)
Your children or your spouse's children, if you will provide more than half of their support from July 1, 2019,
through June 30, 2020, even if the children do not live with you.
Other people if they now live with you and you or your spouse provides more than half of their support and will
continue to provide more than half of their support through June 30, 2020.
For any household member who will be enrolled at least half-time in a degree, diploma, or certificate program at an
eligible postsecondary educational institution any time between July 1, 2019 and June 30, 2020, include the name of
the college.
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