WARNING: If you purposely give false or misleading information, you may be fined, sent to prison or both.
Page 1 of 2
FA20CDVF
OFFICE OF STUDENT FINANCIAL AID
ROBESON COMMUNITY COLLEGE
Student Center Building 13
PO Box 1420
Lumberton, NC 28359
T 910.272.3352 Email: finaid@robeson.edu
F 910.272.3314 Website: https://www.robeson.edu/fa/
2020-2021 Verification
Worksheet- Dependent
Your FAFSA was selected for review in a process called verification. As required by federal regulations, we must ask
you to verify information you submitted on your FAFSA. As part of this process, the Financial Aid office will compare
information from your FAFSA with the documents you are required to submit. If there are differences between your
FAFSA and financial documents, we will make necessary corrections to your FAFSA. Additional documentation may be
requested to resolve discrepancies.
A. Student’s Information
Student’s Name: _____________________________________________ Student ID: ____________________
Address: __________________________________________ City/State/Zip____________________________
Phone #: ______________________________________ Email: ______________________________________
B. Student’s Family Information
List below the people in your parent’s household. Include:
Yourself (the student).
Your parents (including stepparent) even if the student doesn’t live with the parents
Your parent’s other children if the parents will provide more than half of the children’s support from July 1,
2020, through June 30, 2021, even if a child does not live with the student.
Other people if they now live with your parents and your parents 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, 2021.
Number in College: Include in the space below information about any household member (excluding parents) who is, or
will be, enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary educational
institution any time between July 1, 2020, and June 30, 2021, and include the name of the college.
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.
Full Name
Age
Relationship
(Self, Spouse)
College/University
Example: Missy Jones
18
Self
RCC (example)
Self
RCC
If more space is needed, attach a separate page with the student's name and Student Id# at the top
WARNING: If you purposely give false or misleading information, you may be fined, sent to prison or both.
Page 2 of 2
FA20CDVF
OFFICE OF STUDENT FINANCIAL AID
ROBESON COMMUNITY COLLEGE
Student Center Building 13
PO Box 1420
Lumberton, NC 28359
T 910.272.3352 Email: finaid@robeson.edu
F 910.272.3314 Website: https://www.robeson.edu/fa/
2020-2021 Verification
Worksheet- Dependent
B. Student’s Income Information: Check only one box below.
TAX RETURN FILERS: Yes, I have filed or will file a 2018 US Income Tax Return or the foreign equivalent. (Check one of
following):
I used the Data Retrieval Tool (DRT) OR
I will provide a signed 2018 IRS tax return or tax return transcript. If the return was amended, a signed 1040X is also
required.
NOT EMPLOYED: I was not employed and did not earn any income from work in 2018.
NON TAX FILER: I did earn income but was not required to file for 2018.
If you are not required to file a 2018 Federal income tax return, you must submit a Verification of Non-Filing Letter from the IRS dated on or
after October 1, 2018. List below your employer(s) and any income received in 2018. Please submit copies of all W-2 forms. If you did not
keep a copy of your W-2 forms, call the IRS at 1-800-908-9946 to request a Wage and Income Transcript.
C. Parent Income Information: Check only one box below.
TAX RETURN FILERS: Yes, I have filed or will file a 2018 US Income Tax Return or the foreign equivalent. (Check one of
following):
I used the Data Retrieval Tool (DRT) OR
I will provide a signed 2018 IRS tax return or tax return transcript. If the return was amended, a signed 1040X is also
required.
NOT EMPLOYED: One or both parents was not employed and did not earn any income from work in 2018. If you did not file a
2018 Federal income tax return, you must submit a Verification of Non-Filing Letter from the IRS dated on or after October 1, 2018.
NON TAX FILER: One or both parents were employed and earned income but was not required to file for 2018.
If you are not required to file a 2018 Federal income tax return, you must submit a Verification of Non-Filing Letter from the IRS dated on or
after October 1, 2018. List below your parent(s)’ employer(s) and any income received in 2018.Please submit copies of all W-2 forms. If your
parent(s) did not keep a copy of W-2 forms, call the IRS at 1-800-908-9946 to request a Wage and Income Transcript.
Source of Income
W-2
2018 Income
Yes | No
$
Yes | No
$
D. Certification and Signature(s)
Each person signing this form certifies that all the information reported on it is complete and correct. If any person providing information purposely
gives false or misleading information on this worksheet, they may face prosecution, which could result in a fine or jail sentence, or both.
__________________________________________________________ ___________________
Signature of Student Date
__________________________________________________________ ___________________
Signature of Parent Date
Source of Income
W-2
2018 Income
Yes | No
$
Yes | No
$
click to sign
signature
click to edit
click to sign
signature
click to edit
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