2019-2020
Verification Worksheet
Your 2019 -2020 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 institutional verification document
and with any other required documents. If there are differences, your FAFSA information may need to be corrected. If Dependent, you and a parent whose information was reported on the FAFSA
must complete and sign this institutional verification document, attach any required documents, and submit the form and other required documents to us. If Independent, you must complete and
sign this institutional verification document, attach any required documents, and submit the form and other required documents to us. We may ask for additional information. If you have questions
about verification, contact us as soon as possible so that your financial aid will not be delayed.
A. Student's Information
Last Name First Name M.I.
Street Address (include apt. no.) City State Zip Code
ID Number Date of Birth (MMDDYYYY) Email Address Alternate Email Address Home Phone Number Cell Phone Number
B. Student's Family Information (Dependent Student)
Full Name Age Relationship College
Will Be Enrolled at Least Half Time
Missy Jones (example) 18 Sister Central University Yes
Self
Polytechnic University of Puerto Rico
Single (never married) Married (includes remarried) Separated/Divorced
Unmarried and both parents living together
Widowed
V1
Dependent Student Independent Student
B. Student's Information (Independent Student)
Number of Household Members: List below the people in the student's household. Include:
The student.
The student's spouse, if the student is married.
The student's or spouse's children if the student or spouse will provide more than half of the children's support
from July 1, 2019, through June 30, 2020, even if a child does not live with the student.
Other people if they now live with the student and the student or spouse provides more than half of the other
person's support, and will continue to provide more than half of that person's support through June 30, 2020.
Number in College: Include in the space below information about any household member who is, or 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, and include the name of the college.
If more space is needed, provide a separate page with the student's name and ID number at the top.
Student Marital status:
Number of Household Members: List below the people in the parents' household. Include:
The student.
The parents (including a stepparent) even if the student doesn't live with the parents.
The parents' other children if the parents will provide more than half of the children's support from July 1, 2019,
through June 30, 2020, or if the other children would be required to provide parental information if they were
completing a FAFSA for 2019 -2020. Include children who meet either of these standards, even if a child does
not live with the parents.
Other people if they now live with the parents and the parents provide more than half of the other person's
support, and will continue to provide more than half of that person's support through June 30, 2020.
Number in College: Include in the space below information about any household member, excluding the parents,
who is, or 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, and include the name of
the college.
If more space is needed, provide a separate page with the student's name and ID number at the top.
Parent(s) marital status:
Single (never married) Married (or remarried) Separated Divorced/Wdowed
C. Student's Income Information to Be Verified:
1. TAX RETURN FILERS - Important Note: The instructions below apply to the student (and spouse, if married).
Instructions: Complete this section if the student and spouse filed or will file a 2017 IRS income tax return(s). The best way to verify income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA
on the Web at FAFSA.gov. In most cases, no further documentation is needed to verify 2017 income information that was transferred into the student's FAFSA using the IRS DRT if that information was not changed
by the FAFSA filer.
Check the item that applies:
The 2017 Puerto Rican Tax Return will be provided later.The 2017 Puerto Rican Tax Return is provided.
The 2017 IRS Tax Return Transcript(s) will be provided later.The 2017 IRS Tax Return Transcript(s) is provided.
The student has used the IRS DRT in FAFSA on the Web to transfer 2017 IRS income tax return information into the student's FAFSA.
The student has not yet used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2017 IRS income tax return information into the student's FAFSA.
The student is unable or chooses not to use the IRS DRT in FAFSA on the Web, and instead will provide the school with a 2017 IRS Tax Return Transcript(s).
The student is a Puerto Rican resident and filed or will file a Puerto Rican tax return
2. TAX RETURN NONFILERS - The instructions and certifications below apply to the student and spouse, if the student is married. Complete this section if the student and spouse will not file and are not required to
file a 2017 income tax return with the IRS.
Check the item that applies:
The student and spouse were not employed and had no income earned from work in 2017.
The student and/or spouse were employed in 2017 and have listed below the names of all employers, the amount earned from each employer in 2017, and whether an IRS W-2 form or an equivalent
document is provided. [Provide copies of all 2017 IRS W-2 forms issued to the student and spouse by their employers]. List every employer even if the employer did not issue an IRS W-2 form.
If more space is needed, provide a separate page with the student's name and ID number at the top.
Employer's Name
Annual Amount Earned in 2017 IRS W-2 or Equivalent Document provided?
Suzy's Auto Body Shop (example)
$2,000.00(example) Yes(example)
Total Amount of Income Earned from Work:
Note: Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2018 that indicates a 2017 IRS income tax return was not filed with the IRS or other relevant
tax authority. Check the item that applies:
Confirmation of non-filing is provided Confirmation of non-filing will be provided later
