Fillable Verification Worksheet19-20 Financial Aid 2019-2020 Verification Worksheet

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Verification Worksheet19-20 Financial Aid 2019-2020 Verification Worksheet

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

BROWSE HUDSON VALLEY COMMUNITY COLLEGE FORMS

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1. Complete the following information about yourself:
First and Last Name Age Name of College student will attend in 2019-2020
SELF Hudson Valley Community College
2. Complete the following to include other people in your household: (SEE NOTES ON PAGE 4)
Dependent Students
• Your parents, including a step-parent, even if you do not
live with them . Do not include a parent who is not living
in the household due to separation, divorce, or death.
• Parents’ other children if the parents will provide more
than half of the children’s support from July 1, 2019
through June 30, 2020.
• Other people if they now live with the parents AND the
parents provide more than half
of the other person’s
support, and will continue to provide more than half of that
person’s support through June 30, 2020.
Independent Students
• Your spouse (if you are legally married).
• Your children or spouse’s children if the student or spouse
will provide more than half of the children’s support from
July 1, 2019 through June 30, 2020 .
• Other people if they now live with the student AND the
student or spouse provides more than half
of the other
person’s support, and will continue to provide more than
half of that person’s support through June 30, 2020.
First and Last Name Age
Relationship to Student
Name of College relative will attend in 2019-2020
Last Name
First Name
Student ID H00
Social Security Number
Home Phone
Cell Phone
STUDENT
(and spouse, if
applicable)
Asset Type
(See notes on page 4 for assistance)
PARENTS
(of dependent students)
$ 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
2019-2020 Verification Worksheet
SECTION A – HOUSEHOLD INFORMATION
SECTION B – CURRENT ASSET INFORMATION
Page 1
Relationship to Student
Did you, the student, file a 2017 income tax return with the IRS?
Y
ES (select one option from the column below) NO (select one option from the column below)
Student Tax Filers
I have used the IRS Data Retrieval Tool (IRS DRT)
→Submit a copy of all yo
IRS Wage and Income Transcript*
I am unable or chose not to use the IRS DRT
→Submit a 2017 IRS Tax Return Transcript*
IRS Wage and Income Transcript*
Student Non-Tax Filers
I was NOT employed and had no income earned from
work in 2017
→Submit a 2017 IRS Statement of Non Filing*
(dependent students are exempt from this requirement)
I was employed in 2017 but did not file an IRS Tax Return
→Submit a copy of all your 2017 W2 forms OR a 2017
IRS Wage and Income Transcript*
Di
d your parent(s) file a 2017 income tax return with the IRS?
Y
ES (select one option from the column below) NO (select one option from the column below)
Parent Tax Filers
M
y parents have used the IRS Data Retrieval Tool (IRS DRT)
→Submit a copy of par
ents 2017 W2 forms OR a 2017
IRS Wage and Income Transcript*
M
y parents are unable or chose not to use the IRS DRT
→Submit a 2017 IRS Tax Return Transcript*
IRS Wage and Income Transcript*
Parent Non-Tax Filers
Neither parent was employed and neither had any income
earned from work in 2017
→Submit a 2017 IRS Statement of Non Filing*for
each parent
→Submit a statement explaining how the family was
supported in 2017
Par
ent was employed in 2017 but did not file an IRS Tax
Return
→Submit a copy of all parent 2017 W2 forms OR a
2017 IRS Wage and Income Transcript*
→Submit a 2017 IRS Statement of Non Filing*
* IRS Tax Return Transcripts, IRS Statements of Non-Filing and IRS Wage & Income Transcripts may be obtained through:
• ONLINE – https://www.irs.gov/individuals/get-transcript
• Automated Telephone Request – 1-800-908-9946
• Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T
For the requirements to file a tax return, please visit the IRS website at www.irs.gov/pub/irs-pdf/p501.pdf
STUDENT
At any time during 2017 or 2018 did you or anyone in your household
receive benefits from any of the federal programs listed below:
PARENT
NO YES NO YES
Medicaid or Supplemental Security Income (SSI)
Supplemental Nutrition Assistance Program (SNAP)
Free or Reduced Price School Lunch
Temporary Assistance for Needy Families (TANF)
Special Supplemental Nutrition Program for Women, Infants & Children (WIC)
Subsidized / Section 8 housing
Social Security Disability (SSD)
SECTION C – STUDENT TAX INFORMATION
SECTION D – PARENT TAX INFORMATION (for dependent students only)
SECTION E – OTHER INCOME & ASSISTANCE
Page 2
PLEASE READ & SIGN: By signing this worksheet, each person below certifies that all
of the information reported is complete and correct.
WARNING: Purposely giving false or misleading information may result in fines, imprisonment or both.
STUDENT
DURING THE 2017 CALENDER YEAR:
PARENT
NO
YES
AMOUNT
NO YES
AMOUNT
*
Please indicate
whether received
weekly,
bi-weekly,
or monthly.
$
Did you pay child support?
(Do NOT include child support paid for any children included in
the household in section A)
$
$
Did you receive child support?
(Do not include foster care or adoption payments)
$
$
Did you receive veterans’ non education benefits (disability,
death pension, etc.)?
$
$
Did you receive Worker’s Compensation?
$
$
Did you have any untaxed portions of a Pension distribution that
was a Rollover?
$
$
Did you have any untaxed portions of an IRA distribution that
was a Rollover?
$
STUDENT SIGNATURE
DATE
PARENT SIGNATURE
DATE
SECTION E – OTHER INCOME & ASSISTANCE…CONTINUED
SECTION F – SIGNATURES
PLEASE RETURN COMPLETED FORM AND ALL OTHER REQUIRED DOCUMENTS TO:
Hudson Valley Community College, Financial Aid Office, 80 Vandenburgh Ave, Troy, NY 12180
Fax #: 518-629-7479 Email: financialaid@hvcc.edu
Page 3
* Please
indicate
whether received
weekly, bi-weekly,
or monthly.
NOTES
Independent vs. Dependent
A student is considered dependent unless they are: born before January 1, 1996, married, Veteran of the US Armed
Forces, serving on Active Duty of the US Armed Forces, homeless, orphan/ward of the court or under legal guardianship.
Section A (HOUSEHOLD INFORMATION)
Independent Household (Section A) includes student, spouse, and child(ren) that the student supports more than 50%
from 7/1/2019-6/30/2020.
Dependent Household (Section A) includes student, parent(s)* and sibling(s) under the age of 24 that parents
support
more than 50% from 7/1/2019-6/30/2020.
Section B (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.
In
vestments 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
parent own (Coverdell and 529 college savings plans and the refund value of 529 prepaid tuition plans).
In
vestments 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.
B
usiness 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.
Sections C & D (NON-TAX FILERS INFORMATION)
I
f, according to IRS regulation, the student/spouse and/or parent(s) were required to file a 2017 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 online in the
2017 IRS Publication 17 online at www.irs.gov
. (See page 7 for dependent students. See page 5 for independent
students/parents.)
Page 4
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Verification Worksheet19-20 Financial Aid 2019-2020 Verification Worksheet

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Completed 2 January 2020

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