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 with the information
on this form, you and your parent(s)’ 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
FAFSA 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 parent(s)’ financial documents (2019
IRS Tax Return Transcripts, W-2 forms, etc.).
2. Talk to your financial aid administrator if you have questions
about completing this worksheet.
3. Complete and sign the worksheet—you and at least one
parent.
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. Dependent Student’s Information
Name:
SSN/Student ID:
Address:
Date of Birth:
City, State, Zip Code:
Phone Number:
B. Dependent Student’s Family Information
List below the people in your parent(s)’ household. Include:
Yourself and your parent(s) (including stepparent) even if you don’t live with your parent(s).
Your parent(s)’ other children if your parent(s) will provide more than half of their support from July 1, 2021, through
June 30, 2022, or if the other children would be required to provide parental information if they were completing a
FAFSA for 2021-2022, even if they do not live with your parent(s).
Other people if they now live with your parent(s) and your parent(s) 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, excluding your parent(s), 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 the student’s name and student ID number at the top.
C. Dependent Student’s Income Information to be Verified
Full Name
Age
Relationship
College
Will be Enrolled
at Least Half
Time
Self
Redlands Community
College
2021-2022
V4/V5 Dependent 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
1. TAX RETURN FILERSImportant Note: If the student filed, or will file, an amended 2019 IRS tax return, the
student must contact the financial aid administrator before completing this section.
INSTRUCTIONS: Complete this section if 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 2018 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:
The student has used the IRS Data Retrieval Tool in FAFSA on the Web to retrieve and transfer 2019 IRS income
information into the student’s FAFSA, either on the initial FAFSA or when making a correction to the FAFSA.
The student’s school will use the IRS information that was transferred in the verification process.
The student has not yet used the IRS Data Retrieval Tool in FAFSA on the Web, but will use the tool to retrieve
and transfer 2019 IRS income information into the student’s FAFSA once the student has filed a 2019 IRS tax
return. See instructions above for information on how to use the IRS Data Retrieval Tool. The student’s school
cannot complete the verification process until the IRS information has been transferred into the FAFSA.
The student is unable or chooses not to use the IRS Data Retrieval Tool in FAFSA on the Web, and the student
will submit to the school a 2019 IRS Tax Return Transcriptnot a photocopy of the income tax return.
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 2019 IRS tax return was filed).
Check here if the student’s IRS Tax Return Transcript is attached to this worksheet.
Check here if the student’s IRS Tax Return Transcript will be submitted to the student’s school later.
Verification cannot be completed until the IRS Tax Return Transcript has been submitted to the
student’s school.
2. TAX RETURN NONFILERSComplete this section if the student will not file and is not required to file a 2019 income
tax return with the IRS.
Check the box that applies:
The student was not employed and had no income earned from work in 2019.
The student was employed in 2019 and has listed below the names of all the student’s employers, the amount
earned from each employer in 2019, and whether an IRS W-2 form is attached. Attach copies of all 2019 IRS
W-2 forms issued to the student by employers. List every employer even if they did not issue an IRS W-2 form. If
more space is needed, attach a separate page with the student’s name and student ID number at the top.
Employer’s Name
2018 Amount Earned
IRS W-2 Attached?
D. Parent’s Income Information to Be Verified
Revised January 2021
Note: If two parents were reported in Section B of this worksheet, the instructions and certifications below
refer and apply to both parents.
1. TAX RETURN FILERSImportant Note: If the student’s parent(s), filed or will file, an amended 2019 IRS
tax return the student’s financial aid administrator must be contacted before completing this section.
INSTRUCTIONS: Complete this section if the student’s parent(s) 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:
The student’s parent(s) has used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2019 IRS income
information into the student’s FAFSA, either on the initial FAFSA or when making a correction to the FAFSA. The
student’s school will use the IRS information transferred into the student’s FAFSA to complete the verification process.
The student’s parent(s) has not yet used the IRS Data Retrieval Tool, but will use the tool to transfer 2019 IRS
income information into the student’s FAFSA once the parent(s’) IRS tax return has been filed. See instructions
above for information on how to use the IRS Data Retrieval Tool. The student’s financial aid administrator cannot
complete verification until the parent(s’) has transferred IRS information into the student’s FAFSA.
The parent(s) is unable or chooses not to use the IRS Data Retrieval Tool, and the parent(s) will submit to the
student’s school a copy of their 2019 IRS Tax Return Transcript(s)not photocopies of the income tax return.
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 Transcriptand not the
“IRS Tax Account Transcript.” Please use the address on file with the IRS (normally this will be the address used when
your 2019 IRS tax return was filed).
Check here if the parent(s’) IRS Tax Return Transcript is attached to this worksheet.
Check here if the parent(s’) IRS Tax Return Transcript will be submitted to the student’s school later.
Verification cannot be completed until the IRS Tax Return Transcript has been submitted to the
student’s school.
2. TAX RETURN NONFILERSComplete this section if the student’s parent(s) will not file and is not required to file a
2018 income tax return with the IRS.
Check the box that applies:
The parent(s) was not employed and had no income earned from work in 2019.
The parent(s) was employed in 2019 and has listed on the next page the names of all the parent(s’) employers,
the amount earned from each employer in 2019, and whether an IRS W-2 form is attached. Attach copies of all
2019 IRS W-2 forms issued to the parent(s) by employer(s). List every employer even if they did not issue an IRS
W-2 form. If more space is needed, attach a separate page with the student’s name and student ID number at the
top.
Employer’s Name
2019 Amount Earned
IRS W-2 Attached?
Revised January 2021
E. Parent’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 one (or both) of the student’s parents listed in Section B of this worksheet paid child support in 2019.
The parent has 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 2019 for each child. If asked by the 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 2019
F. Certification and Signatures
Each person signing this worksheet certifies that all of
the information reported on it is complete and correct.
The student AND one parent must sign and date.
_________________________________________________ _________________________________
Student’s Signature Date
_________________________________________________ _________________________________
Parent’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.
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
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
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****