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2020-2021
DEPENDENT VERIFICATION
WORKSHEET
Your 20202021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says
that before awarding Federal Student Aid, we may ask you to confirm the information you and your parents reported on your FAFSA. To
verify that you provided correct information the financial aid administrator at your school will compare your FAFSA with the information
on this worksheet and with any other required documents. If there are differences, your FAFSA information may need to be corrected.
You and at least one parent must complete and sign this worksheet, attach any required documents, and submit the form and other
required documents to the financial aid administrator at your school. Your school may ask for additional information. If you have
questions about verification, contact your financial aid administrator as soon as possible so that your financial aid will not be delayed.
A. Student’s Dependent Information
Student’s ID Number
Student’s Date of Birth
City
State
Zip Code
Student’s Email Address
Student’s Home Phone Number (include area code)
B. Dependent Student’s Family Information
List below the people in your parent(s)’ household. Include:
Yourself
Student’s Alternate or Cell Phone Number
Your parent(s) (including a stepparent) even if you don’t live with the parent(s).
Your parent(s)’ other children if the parent(s) will provide more than half of their support from July 1, 2020 through June
30, 2021, or if the other children would be required to provide parental information if they were completing a FAFSA for
20202021. Include children who meet either of these standards, even if they do not live with the parent(s).
Other people if they now live with the parent(s) and the parent(s) provide more than half of their support and will continue
to provide more than half of their support through June 30, 2021.
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, 2020, and June
30, 2021. If more space is needed, attach a separate page with the student’s name and Social Security Number at the top.
Full Name
Ag
e
Relationship
College
Will be Enrolled at
Least Half Time
18
Self
Central University
Yes/No
Student’s Last Name Student’s First Name
Student’s
M.I.
Student’s Street Address (include apt. no.)
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Self
Note: We may require additional documentation if we have reason to believe that the information regarding the
household members enrolled in eligible postsecondary educational institutions is inaccurate.
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Student’s Name: SSN:
C. Dependent Student’s Income Information to Be Verified
1. DEPENDENT STUDENT TAX RETURN FILERSImportant Note: If the student filed, or will file, an amended 2018
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 2018 IRS income tax return. The best way to verify
income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the Web at FAFSA.gov. In most cases, no
further documentation is needed to verify 2018 income information that was transferred into the student’s FAFSA using the
IRS DRT if that information was not changed by the FAFSA filer. 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 transfer 2018 IRS income information into
the FAFSA. Your school will use the IRS information that was transferred in the verification process.
The student has not yet used the IRS Data Retrieval Tool, but will use the tool to transfer 2018 IRS income information
into the FAFSA once 2018 IRS tax return have been filed.
The student is unable or chooses not to use the IRS DRT in FAFSA on the Web, and instead will provide the school with
a 2018 IRS Tax Return Transcript(s).
A 2018 IRS Tax Return Transcript may be obtained through:
Get Transcript by MAIL Go to www.irs.gov, under the Tools heading, click "Get a tax transcript.” Click “Get Transcript
by MAIL.” Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.” The
transcript is generally received within 10 business days from the IRS’s receipt of the online request.
Get Transcript ONLINE Go to www.irs.gov, under the Tools heading, click "Get a tax transcript." Click “Get Transcript
ONLINE.” Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.” To use the
Get Transcript Online tool, the user must have (1) access to a valid email address, (2) a text-enabled mobile phone (pay-as-
you-go plans cannot be used) in the user’s name, and (3) specific financial account numbers (such as a credit card number or
an account number for a home mortgage or auto loan). The transcript displays online upon successful completion of the
IRS’s two-step authentication.
Automated Telephone Request 1-800-908-9946. Transcript is generally received within 10 business days from the IRS’s
receipt of the telephone request.
Paper Request Form IRS Form 4506T-EZ or IRS Form 4506-T. The transcript is generally received within 10 business
days from the IRS’s receipt of the paper request form.
2. DEPENDENT STUDENTS WITH UNUSUAL IRS CIRCUMSTANCEScomplete this section if the student has filed, or
will file a 2018 income tax return with any of the following circumstances.
Check the box that applies:
The student is required to file a 2018 IRS income tax return and has been granted a filing extension by the IRS, must
provide.
A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income Tax
Return,’’ that was filed with the IRS for tax year 2018;
A copy of the IRS's approval of an extension beyond the automatic six-month extension if the individual
requested an additional extension of the filing time for tax year 2018;
Verification of Non-Filing Letter (confirmation that the tax return has not yet been filed) from the IRS or other
relevant tax authority dated on or after October 1, 2019;
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A copy of IRS Form W2 for each source of employment income received for tax year 2018 and,
If self-employed, a signed statement certifying the amount of the individual’s Adjusted Gross Income (AGI) and
the U.S. income tax paid for tax year 2018.
Student’s Name: SSN:
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The student has filed an amended IRS income tax return for tax year 2018, must provide:
A 2018 IRS Tax Return Transcript (that will only include information from the original tax return and does not
have to be signed), or any other IRS tax transcript(s) that includes all of the income and tax information required
to be verified; and
A signed copy of the 2018 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was filed with
the IRS.
The student was the victim of IRS tax-related identity theft, must provide:
A Tax Return Database View (TRDBV) transcript obtained from the IRS, or any other IRS tax transcript(s) that
includes all of the income and tax information required to be verified; and
A statement signed and dated by the tax filer indicating that he or she was a victim of IRS tax-related identity
theft and that the IRS is aware of the tax-related identity theft.
3. DEPENDENT STUDENT TAX RETURN NONFILERSComplete this section if the student, will not file and is not
required to file a 2018 income tax return with the IRS.
Check the box that applies:
The student was not employed and had no income earned from work in 2018.
The student was employed in 2018 and has listed below the names of all the student’s employers, the amount earned
from each employer in 2018, and whether an IRS W-2 form is provided. Copies of all 2017 IRS W-2 forms issued to the
student by employers must be provided. 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 Social Security Number at the top.
Employer’s Name
2018 Amount Earned
IRS W-2 Provided?
Suzy’s Auto Body Shop (example)
$2,000.00(example)
Yes(example)
Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2019 that indicates a 2018
IRS income tax return was not filed with the IRS or other relevant tax authority.
Check here if confirmation of non-filing is provided.
Check here if confirmation of non-filing will be provided later.
D. Parent’s Income Information to Be VerifiedNote: If two parents were reported in Section B of this worksheet, the
instructions and certifications below refer and apply to both parents.
1. PARENT(S) TAX RETURN FILERSImportant Note: Notify the financial aid office if the parents filed separate IRS
income tax returns for 2018 or had a change in marital status after December 31, 2018.
Instructions: Complete this section if the student’s parent(s) filed or will file a 2018 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 at www.FAFSA.gov. In most
cases, no further documentation is needed to verify 2018 income information that was transferred into the student’s FAFSA
using the IRS DRT if that information was not changed by the FAFSA filer. If you need more information about whether or how
to use the IRS Data Retrieval Tool see the student’s financial aid administrator.
Student’s Name: SSN:
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Check the box that applies:
The parent has used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2018 IRS income information into the
student’s FAFSA. The student’s school will use the IRS information transferred into the student’s FAFSA to complete the
verification process.
The parent has not yet used the IRS Data Retrieval Tool, but will use the tool to transfer 2018 IRS income information
into the student’s FAFSA once the parent’s IRS tax return has been filed.
The parent is unable or chooses not to use the IRS Data Retrieval Tool, and the parent will provide the school a copy of
the 2018 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 “Get a Transcript” link under the Tools heading,
or call 1-800-908-9946. Make sure you order the “IRS tax return transcript” and not the “IRS tax account
transcript. It takes up to two weeks for IRS income information to be available for electronic IRS tax return filers,
and up to eight weeks for paper tax return filers. If the parents are married, and separate 2018 tax returns were
filed, 2018 IRS tax return transcripts must be submitted for each parent.
Check here if 2018 IRS tax return transcript(s) is provided.
Check here if IRS tax return transcript(s) will be submitted to the student’s school later. Verification cannot be
completed until the IRS tax return transcript(s) has been submitted to the school.
2. PARENT(S) WITH UNUSUAL IRS CIRCUMSTANCES—Complete this section if the student’s parent(s) has filed, or
will file a 2018 income tax return with any of the following circumstances.
Check the box that applies:
The parent is required to file a 2018 IRS income tax return and has been granted a filing extension by the IRS, must
provide.
A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income Tax
Return,’’ that was filed with the IRS for tax year 2018;
A copy of the IRS's approval of an extension beyond the automatic six-month extension if the individual
requested an additional extension of the filing time for tax year 2018;
Verification of Non-Filing Letter (confirmation that the tax return has not yet been filed) from the IRS or other
relevant tax authority dated on or after October 1, 2019;
A copy of IRS Form W2 for each source of employment income received for tax year 2018 and,
If self-employed, a signed statement certifying the amount of the individual’s Adjusted Gross Income (AGI) and
the U.S. income tax paid for tax year 2018.
The parent has filed an amended IRS income tax return for tax year 2018, must provide:
A 2018 IRS Tax Return Transcript (that will only include information from the original tax return and does not
have to be signed), or any other IRS tax transcript(s) that includes all of the income and tax information required
to be verified; and
A signed copy of the 2018 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was filed with
the IRS.
The parent was the victim of IRS tax-related identity theft, must provide:
A Tax Return Database View (TRDBV) transcript obtained from the IRS, or any other IRS tax transcript(s) that
includes all of the income and tax information required to be verified; and
Student’s Name: SSN:
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A statement signed and dated by the tax filer indicating that he or she was a victim of IRS tax-related identity
theft and that the IRS is aware of the tax-related identity theft.
3. PARENT(S) TAX RETURN NONFILERS—Complete this section if the student’s parent(s) will not file and 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 2018.
The parent(s) was employed in 2018 and has listed below the names of all the parent’s employers, the amount earned from
each employer in 2018, and whether an IRS W-2 form is provided. Copies of all 2017 IRS W-2 forms issued to the
parent(s) by employer(s) must be provided. 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 Social Security Number at the top.
Employer’s Name
2018 Amount Earned
IRS W-2 Provided?
Suzy’s Auto Body Shop (example)
$2,000.00 (example)
Yes (example)
Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2019 that indicates a 2018
IRS income tax return was not filed with the IRS or other relevant tax authority.
Check here if confirmation of non-filing is provided.
Check here if confirmation of non-filing will be provided later
E. 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 whose information was reported on
the FAFSA must sign and date.
Student’s Signature Date
Parent’s Signature Date
Do not mail this worksheet to the U.S. Department of Education. Submit
this worksheet to the financial aid administrator at your school.
You should make a copy of this worksheet for your records.
WARNING: If you purposely give false or misleading
information on this worksheet, you may be fined, be sentenced
to jail, or both.