Fillable V5 Dependent 1920 011719

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V5 Dependent 1920 011719

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Alvin Community College
2019-2020 Verification of FAFSA Information
Group 5 - Dependent
Page 1 of 4
Updated 1/17/2019
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. You and a parent or spouse (if applicable), whose information was reported on the FAFSA, must complete
and sign this 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.
Additional documentation may be required to support the information provided on this form.
Student’s Information
____________________________________________ ________________________ ____________________________
Student’s Last Name First Name M.I. Student’s ACC ID Number Student’s Phone Number
___________________________________________________________________________________________________________
Student’s Street Address (include apt. no.) City/State/Zip Code
Parent Household Information
List below the people in the parents’ household. Include:
The student
The parents (including stepparents)
even if the student doesn’t live with the parents.
The parents’ other children if the parents will provide more than half of their 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 the children do not live with the parents.
Do not include children for which
you or your parents pay child support.
Other people, if they now live with the parents, and the parents provide more than half of their support and will continue to
provide more than half of their support through June 30, 2020.
For household members NOT attending college during the 2019-2020 year, please write “NA” in the college/university column. OR,
for household member who will be enrolled at least half time, excluding parents,
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. If
more space is needed, provide a separate page with the student’s name and ID number at the top.
Full Name Age Relationship
Will be enrolled
in college?
(Yes or No)
If yes, which college/university?
Missy Jones (example)
20
Sister
Yes
Alvin Community College
Self
Yes
Alvin Community College
Note: We may require additional documentation regarding the household members.
Student’s Name _______________________________ Student’s ACC ID Number ________________ V5 - D
Page 2 of 4
Updated 1/17/2019
Student Income Information
Did you file a 2017 tax return?
YES -- Please check a box below.
The student filed a 2017 tax return and used the IRS Data Retrieval Tool to complete the FAFSA.
The student filed a 2017 tax return and did not use, or was unable to use, the IRS Data Retrieval Tool to complete the
FAFSA. Please submit signed copies of your 2017 IRS Tax Return. All W2s, 1099s, worksheets, and schedules must be
included.
NO -- Please check a box below.
The student was not employed and had no income earned from work in 2017.
The student worked or had other income in 2017, but did not and was not required to file a 2017 tax return. List below
the names of all employers, the amount earned from each employer in 2017, and submit a 2017 W2/1099 for each
employer. List every employer even if the employer did not issue an IRS W2 form. If more space is needed, provide a
separate page with the student’s name and ID number at the top.
2017 Amount Earned
$2,000.00
Parent(s) Income Information
Did your parents/step-parents file a 2017 tax return?
YES -- Please check a box below.
The parent(s) filed a 2017 tax return and used the IRS Data Retrieval Tool to complete the FAFSA.
The parent(s) filed a 2017 tax return and did not use or was unable to use the IRS Data Retrieval Tool to complete the
FAFSA. Please submit signed copies of your 2017 IRS Tax Return. All W2s, 1099s, worksheets, and schedules must be
included.
NO -- Please check a box below. Please submit a 2017 Verification of Non-filing from the IRS. Please see “How to Provide Tax
Information for Financial Aid” (available on our website) for assistance.
The parent(s) were not employed and had no income earned from work in 2017.
The parent(s) worked or had other income in 2017, but did not and were not required to file a 2017 tax return. List
below the names of all employers, the amount earned from each employer in 2017, and submit a 2017 W2/1099 for
each employer. List every employer even if the employer did not issue an IRS W2 form. If more space is needed, provide a
separate page with the student’s name and ID number at the top.
Employer’s Name
2017 Amount Earned
Suzy’s Auto Body Shop (example)
$2,000.00
Only
complete
this box if
your parents
did NOT
file taxes.
Only
complete
this box if
you did NOT
file taxes.
Student’s Name _______________________________ Student’s ACC ID Number ________________ V5 - D
Page 3 of 4
Updated 1/17/2019
High School Completion Status
Provide one of the following documents that indicate the student’s high school completion status when the student will begin college
in 2019-2020:
A copy of the student’s final official high school transcript that shows the date when the diploma was awarded (PREFERRED –
to satisfy Financial Aid and ACC Admissions requirements).
A State certificate or transcript received by a student after the student passed a State-authorized examination that the State
recognizes as the equivalent of a high school diploma (GED test, HiSET, TASC, or other State-authorized examination).
For students who completed secondary education in a foreign country, a copy of the “secondary school leaving certificate” or
other similar document. It is recommended that students submit an official high school evaluation to expedite the verification
process.
An academic transcript that indicates the student successfully completed at least a two-year program that is acceptable for full
credit toward a bachelor’s degree.
For a student who was homeschooled in a State where State law requires the student to obtain a secondary school completion
credential for homeschooling (other than a high school diploma or its recognized equivalent), a copy of that credential.
A copy of the student’s high school diploma (will not satisfy ACC some program requirements).
For a student who was homeschooled in a State where State law does not require the student to obtain a secondary school
completion credential for homeschooling (other than a high school diploma or its recognized equivalent), a transcript, or the
equivalent, signed by the student's parent or guardian, that lists the secondary school courses the student completed and includes a
statement that the student successfully completed a secondary school education in a homeschool setting.
A student who is unable to obtain the documentation listed above must contact the financial aid office.
Certifications and Signatures
Each person signing below certifies that all of the
information reported is complete and correct.
The student and one parent whose information was
reported on the FAFSA must sign and date.
________________________________________ ________________________
Student’s Signature Date
________________________________________ ________________________
Parent’s Signature Date
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to jail, or both.
Financial Aid Office
Fax: 281-756-3840
fa@alvincollege.edu
Student’s Name _______________________________ Student’s ACC ID Number ________________ V5 - D
Page 4 of 4
Updated 1/17/2019
The following form must be completed
IN PERSON with an authorized ACC Financial Aid staff member
.
Please email the ACC Financial Aid Office (fa@alvincollege.edu) to ensure that an authorized staff member will be
available to complete the form with you. You must wait for an email response before submitting your forms and
documents.
Identity and Statement of Educational Purpose (To Be Signed at the Institution)
The student must appear in person at Alvin Community College to verify his or her identity by presenting an unexpired valid
government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. The
institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received and
reviewed, and the name of the official at the institution authorized to receive and review the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the Statement of Educational Purpose provided below.
Statement of Educational Purpose
I certify that I _____________________________________ am the individual signing this Statement of
(Print Student’s Name)
Educational Purpose and that the Federal student financial assistance I may receive will only be used for educational
purposes and to pay the cost of attending Alvin Community College for 2019–2020.
_________________________________________ _______________
(Student’s Signature) (Date)
______________________
(Student’s ID Number)
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V5 Dependent 1920 011719

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Completed 15 November 2019

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