Page 1 of 3
2019-2020 DEPENDENT
VERIFICATION WORKSHEET
Your financial aid application has been selected for review in a process called verification. The law says that we must ask you to
confirm the information you reported on your FAFSA. We will compare your FAFSA with the information on this institutional
verification form and with any other required documents. If needed, we will make corrections to your FAFSA electronically. If
you have questions about verification, contact your campus One Stop as soon as possible so that your financial aid will not be
delayed. You and a parent whose information was reported on the FAFSA must complete and sign this institutional verification
document, provide required documents, and submit the form and other required documents to the Financial Aid Office.
_____________________________ _____________ ____________________
Student Last Name First Name Date of Birth Brandman ID Number
_____________________________________________ ____________________
Address City State Zip Phone Number
A. Household Information:
List the people in your parent’s household, along with their relationship to you and their ages. Members of your
household should include:
Yourself (the student)
Your parents (including stepparent) even if you don’t live with them, and
o If your biological or adoptive parents are living together, but are NOT married, BOTH are required
to be listed below, and BOTH should be included on your FAFSA.
Your parents’ other children, even if they don’t live with them, if:
o Your parents will provide more than half
of their support from July 1, 2019 through June 30, 2020
(Do not include children for whom your parents’ pay child support unless they provide more than
half of the child’s support.)
o OR if the other children would be required to provide parental information if they were completing a
FAFSA for 2019-2020.
Other people if they now live with your parents and your parents provide more than half of their support
and will continue to provide more than half of their support through June 30, 2020.
Number in College: Include 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 full 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: additional documentation will be required if we have reason to believe that the information regarding the household
members is inaccurate.
Full Name
Age
Relationship
to Student
Will this person be enrolled
in college at least half time
in 19-20?
College Name
(do not abbreviate)
Self
Yes
Brandman University
Page 2 of 3
_____________________________ ____________________
Student Name Brandman ID Number
B. Student Income Verification
Important Note: This section applies to the student only.
The best way to verify income (if you have already filed your 2017 tax return) is by using the IRS Data Retrieval
Tool (IRS DRT) which is part of FAFSA on the Web at FAFSA.gov
. In most cases, no further documentation is
needed to verify income tax return information that was transferred into your FAFSA using the IRS DRT if that
information was not changed. If you are unable to use the data retrieval, you can obtain a 2017 IRS Tax Return
Transcript at
www.IRS.gov. If you did not file a tax return, you must provide a copy of your W2s for 2017.
Check the box that applies:
I have used the IRS DRT to transfer IRS income tax return information into my FAFSA.
I have not yet used the IRS DRT, but will use the tool to transfer IRS income tax return information
into my FAFSA.
I am unable to use the IRS DRT and instead will provide a 2017 IRS Tax Return Transcript(s).
Check one:
My 2017 IRS Tax Return Transcript has been submitted
My 2017 IRS Tax Return Transcript will be provided on: ______________
Date
I had no income earned from work in 2017 and will not file a 2017 Federal Income Tax Return.
I was employed in 2017 but will not file and am not required to file a 2017 Federal Income Tax
Return. List below the names of all employers and the amount earned from each in 2017. (Submit
copies of all W-2s issued from employers). If you do not have copies of your W-2s you can obtain a
Wage and Income Transcript from the IRS at IRS.gov.
Employer’s Name
IRS W-2
Provided?
Annual Amount
Earned in 2017
Total Amount of Income Earned From Work in 2017
$
Page 3 of 3
_____________________________ ____________________
Student Name Brandman ID Number
C. Parent Income Verification
Important Note: This section applies to the parent(s) included in the household only as reported in Section A.
The best way to verify income is by using the IRS Data Retrieval Tool (IRS DRT) which is part of FAFSA on the
Web at FAFSA.gov
. In most cases, no further documentation is needed to verify 2017 IRS income tax return
information that was transferred into the FAFSA using the IRS DRT if that information was not changed. If you are
unable to use the data retrieval, you can obtain a 2017 IRS Tax Return Transcript at
www.IRS.gov. If you did not
file a tax return, you must provide a confirmation of non-filing for each parent which can be obtained from the IRS
using Form 4506-T and checking box 7.
Check the box that applies:
student’s FAFSA.
information into the student’s FAFSA.
Transcript. If the parents filed separate income tax returns, Tax Return Transcripts must be provided
for
both.
2017 IRS Tax Return Transcript(s) has been submitted
2017 IRS Tax Return Transcript(s) will be provided on: ______________
2017 Federal Income Tax Return.
A IRS Statement of Non-Filing has been submitted for each parent
Federal Income Tax Return. List below the names of all employers and the amount earned from
each in 2017. (Submit copies of
all W-2s issued from employers). List every employer even if the
employer did not issue a W-2.
A IRS Statement of Non-Filing has been submitted
Employer’s Name
IRS W-2
Provided?
Annual Amount
Earned in 2017
Total Amount of Income Earned From Work in 2017
$
I certify that all of the information reported on this worksheet is complete and correct.
________________________________________ _______________
Student Signature
(handwritten signature only) Date
________________________________________ _______________
Parent Signature
(handwritten signature only) Date
WARNING: If you purposely give
false or misleading information you
may be fined, be sentenced to jail, or
both.
Upload completed form to the Student Portal
OR Fax: 866-659-1147 Or Mail to: Brandman University, Financial Aid Office, Third Floor 16355
Laguna Canyon Rd, Irvine, CA 92618
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome