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2019-2020 INDEPENDENT
VERIFICATION WORKSHEET
Your financial aid application has been selected for review in a process called verification. The law says that we must ask you to
confirm the information you reported on your FAFSA. We will compare your FAFSA with the information on this institutional
verification form and with any other required documents. If needed, we will make corrections to your FAFSA electronically. If
you have questions about verification, contact your campus One Stop as soon as possible so that your financial aid will not be
delayed. You must complete and sign this institutional verification document, attach any required documents, and submit the
form and other required documents to the Financial Aid Office.
__________________________________ __________ ____________________
Student’s Last Name First Name Date of Birth Brandman ID Number
__________________________________________________ ____________________
Address City State Zip Phone Number
A. Household Information:
List the people in your household, along with their relationship to you and their ages. For any household member
attending college at least half time in a degree, certificate or diploma program between July 1, 2019 and June
30, 2020, please indicate the college attended. Attach additional pages if necessary. Member of your household
include:
You and your spouse (if married).
Your children and your spouse’s children (even if they don’t live with you) if you will provide more than half
of their support from July 1, 2019 through June 30, 2020. Do not include children for whom you pay child
support unless you provide more than half of their support.
Other people if they now live with you, and you (or your spouse) provide more than half of their support
and will continue to provide more than half of their support through June 30, 2020.
Note: If you are including a parent or another adult (not including your spouse) in the household, complete
the Support Statement Form
. The form is located on the Brandman.edu forms center page. Additional
documentation may be required if we have reason to believe that the information regarding the household
members is inaccurate.
Full Name
Age
Relationship to
Student
Is this person
attending college
at least half-time in
19-20?
College Name
(do not abbreviate)
Self
Yes
Brandman University
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B. Income Verification:
The best way to verify income (if you have already filed your 2017 tax return) is by using the IRS Data Retrieval
Tool (IRS DRT) which is part of FAFSA on the Web at FAFSA.gov
. In most cases, no further documentation is
needed to verify income tax return information that was transferred into your FAFSA using the IRS DRT if that
information was not changed. If you are unable to use the data retrieval tool, you can obtain a 2017 IRS Tax Return
Transcript by going to
www.IRS.gov. If you did not file a tax return, you must provide a confirmation of non-filing
which can be obtained from the IRS using Form 4506-T and checking box 7.
Check the box that applies to you:
I have used the IRS DRT to transfer 2017 IRS income tax return information into the my FAFSA.
I have not yet used the IRS DRT, but will use the tool to transfer 2017 IRS income tax return
information into my FAFSA.
I am unable to use the IRS DRT, and instead will provide a 2017 IRS Tax Return Transcript.
If the student and spouse filed separate 2017 IRS income tax returns, 2017 IRS Tax Return
Transcripts must be provided for
both.
My 2017 IRS Tax Return Transcript(s) have been submitted.
My 2017 IRS Tax Return Transcript(s) will be provided on: ______________
I (and my spouse, if married) were not employed and had no income earned from work in 2017
and will not file a 2017 Federal Income Tax Return.
I have submitted an IRS Statement of Non-Filing
I (and my spouse, if married)
was employed in 2017 but will not file and am not required to file a
2017 Federal Income Tax Return. List below the names of all employers and the amount earned
from each in 2017. Submit copies of
all W-2s issued from employers. If you do not have copies of
your W-2s you can obtain a Wage and Income Transcript from IRS.gov.
I have submitted an IRS Statement of Non-Filing
My 2017 W-2s issued to me and my spouse by employers have been submitted.
Employer’s Name: W2 Provided? Amount Earned in 2017:
________________________________________ ____________ $___________________
________________________________________ ____________ $___________________
________________________________________ ____________ $___________________
________________________________________ ____________ $___________________
Total: $
I certify that all of the information reported on this worksheet is complete and correct.
_______________________________________ ___________________ _________________
Student’s Signature
Brandman ID # Date
(handwritten signature only, typed signatures are not acceptable)
WARNING: If you purposely give false
or misleading information you may be
fined, be sentenced to jail, or both.
Submit completed form via the student portal
OR Fax: 866-659-1147 Mail: Brandman University, Financial Aid Office, Third
Floor 16355 Laguna Canyon Rd, Irvine, CA 92618
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