2020-2021 Dependen
t Number in College Verification Form
Your financial aid application
was selected by the U.S. Department of Education to undergo a process called verification. You and your
parent must complete, sign, and submit this form listing the name and age of each of your pa rent(s)' household members that will be
enrolled at least half -time in a college degree, diploma, or certificate program this year. . You must also include the college name and their
enrollment level. The form must be submitted to the Financial Aid Office to continue the review process and determine your eligibility
for federal student aid.
A. Student Information
__________________________________________________ ________________
Student’s Name (Last, First, M.I.) Student ID - REQUIRED
B. Number in College
List the people in your parent(s)’ household that will be attending college at an eligible postsecondary institution any time between
July 1, 2020 and June 30, 2021, and will be enrolled in a degree, diploma, or certificate program. Household members include the
following:
• Yourself
• Your parent(s)’ other children if your parent(s) will provide more than half of their support fro
m July 1, 2020 through June 30,
2021, or if the other children would be required to provide parental information if they were completing a 2020-2021 federal
financial aid application. Include children who meet either of these descriptions, 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, 2021.
In
the spaces below you should only provide information for household members that will be attending college at an eligible
postsecondary institution during the time period describe above. NOTE: We may require additional documentation if we have reason to
believe that the info
rmation provided below is inaccurate.
First Name
Last Name Age Relationship to You College Name Enrolled in at least
6 credits (half-
time)? Yes or No
EXAMPLE: Missy Jones
18
Sister XYZ University YES
Self
C. Certification and Signatures
Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional information is
attached. The student and one parent MUST sign and date this section.
WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced to jail, or both.
______________________________________________________________________ _______________
Student’s Signature
Date
______________________________________________________________________ _______________
Parent Signature
Date
click to sign
signature
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click to sign
signature
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