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What you should do Your application was selected (Redlands Community College)

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Revised January 2021
Your application was selected for review in a process called
“Verification.” In this process RCC will be comparing
information from your FAFSA application against the
information on this form, your (and your spouse’s, if you are
married) 2019 IRS Tax Return Transcript, W-2 forms or other
financial documents. The law says we have the right to ask you
for this information before awarding Federal aid. If there are
differences between your application information and your
financial documents, you or RCC may need to make
corrections.
Complete this verification form and submit it to the Financial
Aid Office at Redlands Community College as soon as possible,
so that your financial aid won’t be delayed.
What you should do
1. Collect your (and your spouse’s) financial documents (2019
IRS Tax Return Transcript(s), W-2 forms, etc.).
2. Talk to your financial aid administrator if you have questions
about completing this worksheet.
3. Complete and sign this worksheet.
4. Submit the completed worksheet, tax forms, and any other
documents RCC requests.
5. RCC will compare information on this worksheet and any
supporting documents with the information you submitted
on your FAFSA. You or the Financial Aid Office at RCC
may need to make corrections.
A. Independent Student’s Information
Name:
SSN/Student ID:
Address:
Date of Birth:
City, State, Zip Code:
Phone Number:
B. Independent Student’s Family Information
List below the people in your household. Include:
Yourself, and your spouse, if you are married.
Your children, if any, if you will provide more than half of their support from July 1, 2021 through June 30,
2022, or if the child would be required to provide your information if they were completing a FAFSA for
2021–2022. Include children who meet either of these standards, even if they do not live with you.
Other people if they now live with you and you provide more than half of their support and will continue to
provide more than half of their support through June 30, 2022.
Include the name of the college for any household member who will be enrolled at least half time, in a degree,
diploma, or certificate program at a postsecondary educational institution any time between July 1, 2021 and June
30, 2022. If more space is needed, attach a separate page with your name and student ID at the top.
Full Name
Age
Relationship
College
Will be Enrolled
at Least Half
Time
Self
Redlands Community
College
2021-2022
V4/V5 Independent Verification Worksheet
Office of Financial Aid
1300 S Country Club Road – El Reno, OK 73036
405-422-6250 – Fax: 405-422-1463
Revised January 2021
C. Independent Student’s Income Information to Be Verified
1. TAX RETURN FILERS—Important Note: If you (or your spouse, if married) filed, or will file, an amended
2019 IRS tax return, you must contact your financial aid administrator before completing this section.
INSTRUCTIONS: Complete this section if you, the student, filed or will file a 2019 income tax return with the IRS.
The best way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA on the Web. If you have
not already used the tool, go to FAFSA.gov, log in to your FAFSA record, select “Make FAFSA Corrections,” and
navigate to the Financial Information section of the form. From there, follow the instructions to determine if you
are eligible to use the IRS Data Retrieval Tool to transfer 2019 IRS income tax information into your FAFSA. It takes
up to two weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax
return filers, and up to eight weeks for paper IRS tax return filers. If you need more information about when, or
how to use the IRS Data Retrieval Tool see your financial aid administrator.
Check the box that applies:
I, the student, have used the IRS Data Retrieval Tool in FAFSA on the Web to transfer my (and, if married, my
spouse’s) 2019 IRS income information into my FAFSA, either on the initial FAFSA or when making a correction
to the FAFSA. Your school will use the IRS information that was transferred in the verification process.
I, the student, have not yet used the IRS Data Retrieval Tool in FAFSA on the Web, but I will use the tool to transfer
my (and, if married, my spouse’s) 2019 IRS income information into my FAFSA once I have filed my 2019 IRS tax
return. See instructions above for information on how to use the IRS Data Retrieval Tool. The school cannot complete
the verification process until the IRS information has been transferred into the FAFSA.
I, the student, am unable or choose not to use the IRS Data Retrieval Tool in FAFSA on the Web, and I will submit
to the school 2019 IRS Tax Return Transcript(s)—not photocopies of the income tax return(s).
To obtain an IRS Tax Return Transcript, go to www.IRS.gov and click on the “Order a Return or Account Transcript”
link, or call 1-800-908-9946. Then Click on “Order a Transcript” under Item 3. Clicking on “Tax Return Transcript”
under Item 1 will not take you to the correct link. Make sure to request the “IRS Tax Return Transcript” and not the
“IRS Tax Account Transcript.” Please use the address on file with the IRS (normally this will be the address used when
your 2054 IRS tax return was filed).
Check here if your (and, if married, your spouse) IRS Tax Return Transcript(s) is attached to this
worksheet.
Check here if your (and, if married, your spouse) IRS Tax Return Transcript(s) will be submitted to the
school later. Verification cannot be completed until the IRS Tax Return Transcript(s) has been submitted
to your school.
2. TAX RETURN NONFILERS—Complete this section if you, the student (and, if married, your spouse), will not file and
is not required to file a 2019 income tax return with the IRS.
Check the box that applies:
The student (and, if married, your spouse) was not employed and had no income earned from work in 2019.
The student (and/or the student’s spouse, if married) was employed in 2019 and has listed, on the next page,
the names of all employers, the amount earned from each employer in 2019, and whether an IRS W-2 form is
attached. Attach copies of all 2019 W-2 forms issued to you (and, if married, to your spouse) by employers. List
every employer even if the employer did not issue an IRS W-2 form. If more space is needed, attach a separate page
with student’s name and student ID number at the top.
Revised January 2021
Employer’s Name
2019 Amount Earned
IRS W-2 Attached?
D. Independent Student’s Other Information to Be Verified
1. SNAP (food stamps)
Check here if one of the persons listed in Section B of this worksheet received benefits from the Supplemental Nutrition
Assistance Program (SNAP) (formerly known as food stamps) in 2019 or 2020. If asked by the student’s school, I will
provide documentation of the receipt of SNAP benefits during 2019 and/or 2020.
2. CHILD SUPPORT PAID
Check here if either I, or if married, my spouse who is listed in Section B of this worksheet, paid child support in
2020. I have indicated below the name of the person who paid the child support, the name of the person to whom
the child support was paid, the names of the children for whom child support was paid, and the total annual
amount of child support that was paid in 2020 for each child. If asked by my school, I will provide documentation
of the payment of child support. If more space is needed, attach a separate page with the student’s name and
student ID number at the top.
Name of Person Who Paid Child
Support
Name of Person to Whom
Child Support was Paid
Name of Child for Whom
Support was Paid
Amount of Child
Support Paid in 2020
E. Certification and Signature
I certify that all of the information reported on this
worksheet is complete and correct. The student must
sign this worksheet. If married, the spouse’s signature
is optional.
_________________________________________________ _________________________________
Student’s Signature Date
_________________________________________________ _________________________________
Spouse’s Signature Date
WARNING: If you purposely give false
or misleading information on this
worksheet, you may be fined, be
sentenced to jail, or both.
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Revised January 2021
Name
SSN/Student ID
Street Address
City
State
Zip
Phone (Area Code and Number) ______________________
The student must appear in person at Redlands Community College to verify his or her identity
by presenting valid government-issued photo identification (ID), such as, but not limited to, a
driver’s license, other state-issued ID, or passport. The institution will maintain a copy of the
student’s photo ID that is annotated with the date it was received and the name of the official at
the institution authorized to collect the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the following:
Statement of Educational Purpose
I certify that I _____________________________ am the individual signing this
(Print Student’s Name)
Statement of Educational Purpose and that the federal student
financial assistance I may receive will only be used for educational
purposes and to pay the cost of attending Redlands Community
College for 2021-2022.
___________________________________ _______________
(Student’s Signature) (Date)
______________________
(Student’s ID Number)
Verified By: __________
****If you are not able to complete this form in our office please contact us: Ph. (405) 422-6250)*****
2021-2022
V5 Identity and Statement of Educational Purpose
(To Be Signed at the Institution)
Office of Financial Aid
1300 S Country Club Road – El Reno, OK 73036
405-422-6250 – Fax: 405-422-1463
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Completed 3 February 2021

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