Fillable Verification Worksheet18-19 Mastrangelo Financial Aid Center 2018-2019 Verification Worksheet

Fill Online, Printable, Fillable, Blank Verification Worksheet18-19 Mastrangelo Financial Aid Center 2018-2019 Verification Worksheet Form

Use Fill to complete blank online HUDSON VALLEY COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Verification Worksheet18-19 Mastrangelo Financial Aid Center 2018-2019 Verification Worksheet

On average this form takes 38 minutes to complete

The Verification Worksheet18-19 Mastrangelo Financial Aid Center 2018-2019 Verification Worksheet form is 6 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 152 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Hudson Valley Community College

BROWSE HUDSON VALLEY COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
HVCC Financial Aid Office Phone 518-629-7150 Guenther Room 110
80 Vandenburgh Ave Fax 518-629-7479 Monday-Friday
Troy, NY 12180 financialaid@hvcc.edu 8AM-5PM
Page 1
FAILURE TO COMPLETE THE VERIFICATION PROCESS IMMEDIATELY WILL RESULT IN THE FORFEIT OF FEDERAL STUDENT AID ELIGIBILITY.
SECTION A – HOUSEHOLD INFORMATION
(See notes on page 4 for assistance determining who to include in this section)
Full Name
Date of Birth
Relationship
COLLEGE attending in 2018-2019
Self (student)
Hudson Valley Community College
SECTION B – CURRENT VALUE OF STUDENT ASSETS
(See notes on page 4 for assistance)
SECTION C – STUDENT 2016 TAX INFORMATION
(IF YOU DID NOT FILE TAXES IN 2016 SKIP TO SECTION D)
Provide the Financial Aid Office with copies of all 2016 IRS W-2 forms issued to the student and spouse by their employers.
AND check the applicable box below:
The student/spouse has already used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2016 IRS income tax return
information into the student’s FAFSA.
The student/spouse has not yet used the IRS Data Retrieval Tool in FAFSA on the Web, but will use the tool to transfer 2016 IRS
income tax return information into the student’s FAFSA.
The student/spouse is unable to use the IRS Data Retrieval Tool in FAFSA on the Web, and instead will provide the school with a
2016 IRS Tax Return Transcript(s).
A 2016 IRS Tax Return Transcript may be obtained through:
• Get Transcript ONLINE or by MAIL – Go to www.irs.gov, click "Get Your Tax Record."
Click “Get Transcript Online” or “Get Transcript by Mail”. Make sure to request the “IRS Tax Return Transcript”
and NOT the “IRS Tax Account Transcript.”
• Automated Telephone Request – 1-800-908-9946
• Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T
Last Name
First Name
Student ID H00
Social Security Number
Home Phone
Cell Phone
Asset Type
Current balance of cash, savings and checking accounts
Net worth of your current investments
Net worth of current business and/or investment farm
Mastrangelo Financial Aid Center
2018-2019 Verification Worksheet
Page 2
SECTION D - STUDENT NON-TAX FILERS 2016 INCOME INFORMATION
Complete this section if the student and/or spouse will not file and are not required to file a 2016 income tax return with the
IRS. (Please refer to notes on page 4 for where to locate the 2016 IRS filing requirements.)
If the student is independent, you must also provide documentation from the IRS that indicates a 2016 IRS income tax return
was not filed by student and/or spouse. You can obtain a non-filing statement from the IRS by submitting IRS Form 4506-T. This
requirement does not apply to dependent students.
Check the box that applies:
The student and/or spouse were not employed and had no income earned from work in 2016.
The student and/or spouse were employed in 2016 but did not file and were not required to file a federal tax return.
Provide the Financial Aid Office with copies of all 2016 IRS W-2 forms issued to the student and/or spouse by their
employers
SECTION E - STUDENT OTHER INCOME & ASSISTANCE
Between Jan 1, 2016 and December 31, 2016: NO YES
Did you receive Medicaid or Supplemental Security Income (SSI)?
Did you receive Supplemental Nutrition Assistance (SNAP)?
Did you receive Free or Reduced Price School Lunch?
Did you receive Temporary Assistance for Needy Families (TANF)?
Did you receive Special Supplemental Nutrition Program for Women, Infants, &Children (WIC)?
Did you receive Subsidized/ Section 8 housing?
Did you receive Social Security Disability (SSD)?
DURING THE 2016 CALENDER YEAR: NO YES
AMOUNT
*Please indicate whether received
weekly, bi-weekly or monthly
Did you pay child support?
List all child(ren) for whom the child support was paid:
_____________________________________________________
List the person(s) who received the child support you paid:
_____________________________________________________
$
Did you receive child support?
(Do not include foster care or adoption payments)
$
Did you report college grant/scholarship aid to the IRS as income?
(includes Americorps benefits, as well as grant and scholarship portions of
fellowships and assistantships.)
$
Did you receive housing, food and other living allowances paid to
members of the military, clergy, and others (including cash payments and
cash value of benefits)?
$
Did you receive veterans’ non education benefits (disability, death
pension, etc.)?
$
Did you receive Worker’s Compensation?
$
Did you receive disability OTHER THAN Social Security Disability?
$
Did you have taxable earnings from need-based employment programs?
(federal work study, fellowship, assistantship or a co-operative education
program)
$
Page 3
SECTION F - STUDENT LIVING SITUATION
SECTION G - STUDENT SIGNATURE
PLEASE READ & SIGN: By signing this worksheet, I certify the information reported is complete and correct.
WARNING: Purposely giving false or misleading information may result in fines, imprisonment or both.
IF YOU ARE AN INDEPENDENT STUDENT
IF YOU ARE A DEPENDENT STUDENT CONTINUE ON TO PAGE 5
(See notes on page 4 for clarification)
Where did you live in 2016?
Lived with parents
Owned or rented your home/apartment
3rd Party (e.g. rehabilitation center, homeless shelter, correctional facility)
Please provide name and location of the 3rd Party:______________________________________________
Did this 3rd Party provide all of your living expenses in 2016?: YES or NO
Please provide us with ALL relevant information (including dates and support provided):
__________________________________________________________________________________________
__________________________________________________________________________________________
Lived with a friend, significant other, legal guardian, relative (NOT A PARENT)
Please provide their name and relationship to you:________________________________________________
Did this person give you any money in 2016 to cover living expenses?: YES or NO
If YES, provide amount for 2016: $_____________
If NO, did this person provide all of your support in 2016 without giving you money? YES or NO
Please provide us with ALL relevant information (including dates and support provided):
__________________________________________________________________________________________
__________________________________________________________________________________________
STUDENT SIGNATURE
DATE
Page 4
NOTES
Independent vs. Dependent
A student is considered dependent unless they are born before January 1, 1995, are married, a veteran of the US Armed
Forces, serving on active duty in the US Armed Forces, homeless, orphan/ward of the court or under legal guardianship.
-Independent students must complete Section A-G. -Dependent students must complete Sections A-M.
Section A (HOUSEHOLD INFORMATION)
-Independent Household (Section A) includes student, spouse, and child(ren) that the student supports more than 50%
from 7/1/2018-6/30/2019.
-Dependent Household (Section A) includes student, parent(s)* and sibling(s) (under the age of 24) that parents support
more than 50% from 7/1/2018-6/30/2019.
*Parent(s) in household include either: 1) one or both biological/adoptive parents (depending on their marital status and if
they both live in the household OR 2) one biological/adoptive parent PLUS one step-parent (if re-married)
Section B and/or H (ASSETS INFORMATION)
Net worth means current value minus debt. If net worth is $1 million or more, enter $999,999. If net worth is negative,
enter $0.
Investments INCLUDE real estate (do not include the home you live in), rental property, trust funds, UGMA and UTMA
accounts for which you are the owner of, money market funds, mutual funds, certificates of deposit, stocks, stock options,
bonds, other securities, installment and land sale contracts (including mortgages held), commodities, etc. Investment
value includes the market value of these investments as of today. Investment debt means only those debts that are related
to the investments. Investments also include qualified educational benefits or education savings accounts that student or
parents own (Coverdell and 529 college savings plans and the refund value of 529 prepaid tuition plans).
Investments DO NOT INCLUDE the home you live in, the value of life insurance and retirement plans (401[k] plans,
pension funds, annuities, non- education IRAs, Keogh plans, etc.), Investments also do not include UGMA and UTMA
accounts for which you are the custodian, but not the owner.
Business and/or investment farm value includes the market value of land, buildings, machinery, equipment, inventory,
etc. Business and/or investment farm debt means only those debts for which the business or investment farm was used as
collateral. Do not include the value of a small business if your family owns and controls more than 50 % of the business
and the business has 100 or fewer full-time or full-time equivalent employees. For small business value, your family
includes (1) persons directly related to you, such as a parent, sister, cousin, or (2) persons who are or were related to you
by marriage, such as a spouse, stepparent or sister-in-law. Investment farm does not include the value of a family farm
that you (your spouse/parents) live on and operate.
Section D and/or J (NON-TAX FILERS INFORMATION)
If, according to IRS regulation, the student/spouse and/or parent(s) were required to file a 2016 federal tax return but
failed to do so, all financial aid processing will be delayed until the return is filed, processed by the IRS and appropriate
documentation is submitted to the Financial Aid Office. Information regarding filing limits can be found in the 2016 IRS
Publication 17 online at www.irs.gov
. (See page 7 for dependent students. See page 5 for independent students/parents.)
P
age 5
THE FOLLOWING SECTIONS ARE TO BE COMPLETED BY PARENT(S)
SECTION H – CURRENT VALUE OF PARENT ASSETS
(See notes on page 4 for assistance)
SECTION I - PARENT 2016 TAX INFORMATION
(IF YOU DID NOT FILE TAXES IN 2016 SKIP TO SECTION J)
Important Note: The instructions below apply to each parent included in the household. Notify the Financial Aid Office if the
parents filed separate IRS income tax returns for 2016 or had a change in marital status after December 31, 2016
.
Provide the Financial Aid Office with copies of all 2016 IRS W-2 forms issued to the parent(s) by their employers
A
ND check the applicable box below:
The parent(s)have used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2016 IRS income tax return information
into the student’s FAFSA.
T
he parent(s)have not yet used the IRS Data Retrieval Tool in FAFSA on the Web, but will use the tool to transfer 2016 IRS
income tax return information into the student's FAFSA.
The parent(s)are unable to use the IRS Data Retrieval Tool in FAFSA on the Web, and instead will provide the school with a
2016 IRS Tax Return Transcript(s).
A 2016
IRS Tax Return Transcript may be obtained through:
• Get Transcript ONLINE or by MAIL – Go to www.irs.gov
, click "Get Your Tax Record."
Click “Get Transcript Online” or “Get Transcript by Mail”. Make sure to request the “IRS Tax Return Transcript”
a
nd NOT the “IRS Tax Account Transcript.
”
• Automated Telephone Request – 1-800-908-9946
• Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T
SECTION J - 2016 INCOME INFORMATION FOR PARENT NON-TAX FILERS
Complete this section if the parents will not file and are not required to file a 2016 income tax return with the IRS.
(Please refer to notes on page 4 for where to locate the 2016 IRS filing requirements.)
You must provide documentation to the Financial Aid Office from the IRS that indicates a 2016 IRS income tax return
was not filed with the IRS. You can obtain a non-filing statement from the IRS by submitting IRS Form 4506-T.
C
heck the box that applies:
Neither parent was employed, and neither had income earned from work in 2016.
O
ne or both parents were employed in 2016 but did not file and were not required to file a federal tax return.
Provide the Financial Aid Office with copies of all 2016 IRS W-2 forms issued to the parent(s) by their employers
Asset Type
Current balance of cash, savings and checking accounts
Net worth of your current investments
Net worth of current business and/or investment farm
Page 6
SECTION K - PARENT(S) OTHER INCOME & ASSISTANCE
SECTION L - OTHER RELEVANT INFORMATION FOR PARENT(S)
If parent(s) did not have income AND did not receive any type of assistance for 2016, please provide an
explanation regarding how the family was supported in 2016
:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
SECTION M - PARENT SIGNATURE
PLEASE READ & SIGN: By signing this worksheet, I certify the information reported is complete and correct.
WARNING: Purposely giving false or misleading information may result in fines, imprisonment or both.
PARENT SIGNATURE
DATE
Between Jan 1, 2016 and December 31, 2016:
NO
YES
Did you receive Medicaid or Supplemental Security Income (SSI)?
Did you receive Supplemental Nutrition Assistance (SNAP)?
Did you receive Free or Reduced Price School Lunch?
Did you receive Temporary Assistance for Needy Families (TANF)?
Did you receive Special Supplemental Nutrition Program for Women, Infants, &Children (WIC)?
Did you receive Subsidized/ Section 8 housing?
Did you receive Social Security Disability (SSD)?
DURING THE 2016 CALENDER YEAR: NO YES
AMOUNT
*Please indicate whether
received weekly, bi-
weekly or monthly
Did you pay child support?
List all child(ren) for whom the child support was paid:
_____________________________________________________
List the person(s) who received the child support you paid:
_____________________________________________________
$
Did you receive child support?
(Do not include foster care or adoption payments)
$
Did you report college grant/scholarship aid to the IRS as income? (includes Americorps
benefits, as well as grant and scholarship portions of fellowships and assistantships.)
$
Did you receive housing, food and other living allowances paid to members of the
military, clergy, and others (including cash payments and cash value of benefits)?
$
Did you receive veterans’ non education benefits (disability, death pension, etc.)?
$
Did you receive Worker’s Compensation?
$
Did you receive disability OTHER THAN Social Security Disability (SSD)?
$
Did you have taxable earnings from need-based employment programs? (federal work
study, fellowship, assistantship or cooperative education program)
$
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Verification Worksheet18-19 Mastrangelo Financial Aid Center 2018-2019 Verification Worksheet

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 1 December 2019

Message

View Audit Log
Print With Audit Log
Duplicate Document