Financial Aid
450 North Avenue • Battle Creek, MI 49017-3397
269-965-4123 • FAX 269-966-4089nancial-aid
2019-2020 Independent Student
Verication Worksheet
You were selected for VERIFICATION
by the Department of Education.
Before the Financial Aid Oce
(FAO) can award Federal Student
Aid, please conrm the information
you and your parents reported on
your 2019-2020 FAFSA. A Kellogg
Community College Financial Aid
Administrator will compare the
information reported on your
FAFSA with the information on this
worksheet. If there are dierences,
your FAFSA information will need
to be corrected. Complete and
sign this worksheet, attach any
required documents, and submit
the form to the FAO. The FAO may
ask for additional information. If you
have questions about verication,
contact the FAO as soon as possible
so that your nancial aid will not be
Last Name First Name M.I. Student ID#
Street Address (include apt. no.) Social Security #
City State Zip Date of Birth
Home Phone Cell Phone Alternative Phone
In the box below list ALL members of your household. If you have questions
regarding household members, contact the FAO. Your household should include:
The student
The student’s spouse, if the student is married.
The student’s or spouses children if the student or spouse will provide more
than half of their support from July 1, 2019, through June 30, 2020, even if the
children do not live with the student.
Other people if they now live with the student and the student or spouse
provides more than half of their support and will continue to provide more
than half of their support through June 30, 2020.
Full Name Age
Male or Female
M or F Relationship College
*Will be Enrolled at
Least Half Time
(Yes or No)?
Self Kellogg Community College Yes
*For any household member who will be enrolled at least half time (6 credits) in a degree, diploma, or certicate 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.
NOTE: We may require additional documentation if we have reason to believe that the information regarding the household members
enrolled in eligible postsecondary educational institutions is inaccurate.
a. Tax Return Filers — Complete this section if you, the student (and or your spouse, if married), has led or will le a 2017 tax return with the
IRS. You have already used the IRS Data Retrieval Tool (DRT), which is part of your FAFSA. For assistance using the DRT see instructions on the
last page of this worksheet. If you or your spouse have led an Amended 2017 IRS Federal Tax Return, contact the FAO.
Check the box that applies:
I have led a 2017 Federal IRS Tax Return and have used the DRT through FAFSA
I will le and have NOT yet used the IRS DRT through FAFSA, however I will use the DRT later
I was UNABLE or chose not to use the DRT through FAFSA, and will submit a signed 1040, 1040A, or 1040EZ IRS Individual Federal Tax
Return separately:
Attach your signed 2017 Federal Tax Return or Tax Return Transcript to this worksheet
Submit Tax Return Transcript at a later date
To obtain an IRS Tax Return Transcript, go to to request an electronic transcript or
to receive it by mail. You can also call 1-800-908-9946. Make sure to request a Tax Return Transcript and NOT the Account
I have led an amended tax return (1040X) and will attach to this worksheet or submit at a later date.
b. Tax Return Non-lers — Only Select ONE Option. Complete this section if you, the student (and, if married, your spouse) will not le an IRS
Tax Return. ALL Non-lers must submit a 2017 “IRS Verication of Non-ling Letter which can be retrieved from the IRS online at http://www. or by mail by submitting an IRS Form 4506-T, found at
I was not employed, did not have any income earned from working during the year of 2017
I was employed however, I was not required to le a 2017 Federal IRS Tax Return. If so, complete the box below and attach the
box below and attach the following:
Attach copies of all 2017 W-2’s and/or 1099 forms
Submit a Household Resources Verication form, found on webpage or at the FAO
Name of Employer Amount Earned in 2017 W-2 Attached? Yes or No
Suzys Auto Body Shop (example) $2,000.00 (example) Yes (example)
Part IV. ADDITIONAL INCOME — Use the table below to report annual amounts for you and your spouse. Be sure to enter
zeros if no funds were received in 2017.
2017 Additional Financial Information Student’s /Spouse Amount
Combat pay or special combat pay. Only enter the amount that was taxable and include in
your adjusted gross income. Combat pay is reported on the W-2 in Box 12, Code Q.
Payments to tax-deferred pension and savings plans including, but not limited to, amounts
reported on the W-2 forms in Boxes 12a-12d, Codes D, E, F, G, H and S. (Do not include DD)
Child support received for any of your children. Don’t include foster care or adoption
payments. Provide names of child(s) you received child support for:
Housing, food and other living allowances paid to members of the military, clergy and
others (Including cash payments and cash value of benets.) Don’t include the value of
on-base military housing or the value of a basic military allowance for housing.
Veterans non-education benets such as disability, Death Pension, or Dependency &
Indemnity Compensation (DIC) and/or VA Educational Work-Study allowances.
Other untaxed income not reported in items 45a through 45h or 93a- 93h, such as workers’
compensation, disability, etc. Don’t include student aid, EIC, additional child tax credit,
welfare payments, untaxed SS benets, SSI, WIA educational benets, on-base
military housing or a military housing allowance, combat pay, benets from exible
spending arrangements (e.g. cafeteria plans), foreign income exclusion or credit for
federal tax on special fuels.
Money received, or paid on your behalf (e.g. bills), not reported elsewhere on this form. $
I cerfy that ALL informaon reported on
this worksheet is complete and correct. The
student must sign and date this worksheet. If
married, the spouse’s signature is oponal.
WARNING: If you purposely give false
or misleading information on this work-
sheet, you may be ned, sentenced to jail,
or both.
Student Signature Date
Spouse Signature (optional) Date
Kellogg Community College
Financial Aid Oce
450 North Avenue
Battle Creek, MI 49017
Email: 
Phone: (269) 965-4123
FAX #: (269) 966-4089
Using the IRS Data Retrieval Tool
Access your FAFSA at and log into your account.
Once logged in, click on the option to “Make FAFSA Corrections” (this will take you to your completed FAFSA information). If
federal taxes have been led, go to the tax information section and update status to “already completed” taxes. Answer the
series of questions that follow. If you answer “no to each question an option will be provided to “link to IRS”.
Enter your name and address information EXACTLY as it appears on your 2017 tax form. If the tool can locate tax information,
click the option to “transfer now”. If you need to use the IRS Data Tool for the student, repeat steps in the student section of the
FAFSA. Once you are done make sure to next through the rest of the FAFSA and complete the new submission on the “Sign and
Submit” page.
Requesting an IRS Tax Return Transcript
Go to , click “Get My Tax Record”. Then choose Get Transcript Online” or “Get Transcript by Mail.
If you already have an account established, you can log in to access your Tax Return Transcript. To “Get Transcript by Mail simply
chose that option and supply requested the requested information.
Request can also be made by telephone at (800) 908-9946 or by completing a 4506-T that can be mailed or faxed to the IRS. In
any case make sure that you request the “IRS Tax Return Transcript” and NOT “IRS Account Transcript. The transcripts requested
by “Get Transcript by Mail”, Phone and 4506-T are received within 10 business days from the IRS’s receipt of your request.
Verication of Non-Filing Letter
Go to, click Get My Tax Record”. Then choose “Get Transcript online”. The Get Transcript Online” tool is currently
unavailable for new users. If you already have an account established, you can log in to access a Verication of Non-ling letter.
Request can also be made by telephone at (800) 908-9946 or by completing a 4506-T that can be mailed or faxed to the IRS.
Verication of Non-ling letters requested by phone or 4506-T are generally received within 10 business days from the IRS’s
receipt of your request.
Updated 5/19