Student’s Name ____________________________ Student’s ID Number _____________
Page 1 of 3
Updated January, 2020
Verification information
What is verification and why was I selected?
Verification is the process by which certain required information on the FAFSA is reviewed for accuracy
and completeness.
Students are selected for verification for one of the following reasons:
The Department of Education Central Processing System found inconsistencies and/or potential
errors in the student’s FAFSA
Random selection
School selection
Steps to complete verification:
Complete all required sections of this worksheet, sign it, and send the completed worksheet along
with any supporting documentation to the Office of Student Financial Aid.
The Office of Student Financial Aid will notify you via your Edison email account if there is additional
documentation needed or any other questions to be answered.
The Office of Student Financial Aid cannot process your financial aid package and
determine your aid eligibility until verification has been completed, so it is imperative that
you provide the required documents as soon as possible.
Section 1 - Student Information
____________________________________________ ____________________________
Student’s Last Name First Name M.I. Student’s Social Security Number
_____________________________________________ ____________________________
Student’s Street Address (include apt. no.) Student’s Date of Birth
_____________________________________________ ____________________________
City State Zip Code Student’s Email Address
_____________________________________________ ____________________________
Student’s Home Phone Number (include area code) Student’s Alternate or Cell Phone Number
STUDENT INFORMATION
V4-D: 2020-2021 DEPENDENT STUDENT
Custom Verification Worksheet
Student’s Name ____________________________ Student’s ID Number _____________
Page 2 of 3
Updated January, 2020
Provide one of the following documents that indicate the student’s high school completion status when
the student will begin college in 2020-2021.
Check the box that applies:
My official high school transcript, noting graduation date, was previously submitted to Edison
State Community College.
My official high school transcript, noting graduation date, is attached. (The transcript must
remain in sealed envelope as received from the school.)
My official General Educational Development (GED) transcript and test scores proving
graduation was previously submitted to Edison State Community College.
My official General Educational Development (GED) transcript and test scores proving
graduation, is attached. (The transcript and test scores must remain in sealed envelope as
received from the agency.)
My official homeschool transcript, signed by the student's parent or guardian, listing the
secondary school courses and grades the student completed and documents the successful
completion of a secondary school education in a homeschool setting was previously submitted
to Edison State Community College.
My official homeschool transcript, signed by the student's parent or guardian, listing the
secondary school courses and grades the student completed and documents the successful
completion of a secondary school education in a homeschool setting is attached.
I understand I must meet with Financial Aid Counselor to present a valid (not expired)
government-issued photo identification as part of the verification process. (A valid government-
issued photo ID includes but is not limited to a driver’s license, state ID, or passport.)
I understand I must meet with a Financial Aid Counselor to sign a statement certifying the federal
financial aid received will only be used for educational purposes to pay the cost of attending the
institution for 2020-2021.
HIGH SCHOOL COMPLETION STATUS
IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE
Student’s Name ____________________________ Student’s ID Number _____________
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Updated January, 2020
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
Do not mail this worksheet to the U.S. Department of Education
Submit this worksheet to:
Edison State Community College
Office of Student Financial Aid
1973 Edison Dr.
Piqua, OH 45356
CERTIFICATIONS AND SIGNATURES
WARNING: If you purposely give false or
misleading information on this worksheet, you
may be fined, sent to prison, or both.
click to sign
signature
click to edit
click to sign
signature
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