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your FAFSA with information submitted on your tax (Randolph-Macon College)

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2021-2022 RMC STANDARD VERIFICATION WORKSHEET – V1
Student Name: ______________________________________________
Last First M
RMC ID#: __________________
Office of Financial Aid
P. O. Box 5005, 114 College Avenue
Ashland, VA 23005
FAX: (804) 752-3719
Email: financialaiddocs@rmc.edu
The US Department of Education and/or Randolph-Macon College selected your file for verification. We must verify the information on
your FAFSA with information submitted on your tax returns. Please complete the IRS data retrieval process or submit your tax return
transcripts to R-MC. Complete and return this form with all W2 forms and schedules within thirty days or no later than May 1, 2022 if
enrolled for the full academic year or December 1, 2021 if enrolled for the fall only. Your financial aid offer is not final until all
verification requirements have been satisfied and any necessary corrections have been made.
STEP 1 – FAMILY INFORMATION – LIST EVERYONE IN HOUSEHOLD
If you are a DEPENDENT STUDENT, include: If you are an INDEPENDENT STUDENT, include:
1 Yourself 1 Yourself
2 Your parent(s) (including step-parents) whose data is reported 2 Your spouse (if you are married)
on the FAFSA 3 Your children if you will provide more than half of their
3 Your parent(s) other dependent children if a) your parent(s) will provide support from July 1, 2021 through June 30, 2022
more than half of their support from July 1, 2021 through June 30, 2022, 4 Other people only if they live in your household and
or b) the children would be required to provide parental information you provide more than half of their support and will
when applying for Federal Student Aid continue to do so from July 1, 2021 through June 30, 2022
4 Other people only if they now live in your parent(s) household and your
parent(s) will provide more than half of their support from July 1, 2021
through June 30, 2022
Full Name
Age
Relationship to
Applicant
Name of College/Degree
Program (i.e. BA, BS) (if at
least half-time 2021-2022)
Enrolled at least
Half-time
(YES or NO)
SELF
R-MC/
(Attach an additional sheet if you need more space)
STEP 2 – STUDENT TAX RETURN TRANSCRIPT & INCOME INFORMATION – CALENDAR YEAR 2019
Are you or will you be required to file a 2019 Federal Income Tax Return? _____ YES _____ NO
A. If YES, check the appropriate items:
_____ 1. Attach a signed copy of your 2019 1040 Federal Tax Return OR 2019 Federal Tax Return Transcript.
_____ 2. I have used the IRS Tax Retrieval Tool through the FAFSA.
_____ 3. Attach copy(s) of ALL 2019 W-2 Statements. How many? (_____). Attach copies of ALL Tax Schedules from 2019.
Continue to STEP 4.
B. If NO, complete the table below and attach copies of ALL 2019 W-2 forms (Independent Students ONLY - a verification of Non-
Filing letter from the IRS dated on or after October 1, 2020). DO NOT LEAVE BLANK! Continue to STEP 3.
Source of Income (Fill out only if you did NOT file taxes)
Amount Earned In 2019
TOTAL
_________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
STEP 3 – SPOUSE OR PARENT TAX RETURN TRANSCRIPT & INCOME INFORMATION – CALENDAR YEAR 2019
Are you or will you be required to file a 2019 Federal Income Tax Return? _____ YES _____ NO
A. If YES, check the appropriate items:
_____ 1. Attach a signed copy of your 2019 1040 Federal Tax Return OR 2019 Federal Tax Return Transcript.
_____ 2. I have used the IRS Tax Retrieval Tool through the FAFSA.
_____ 3. Attach copy(s) of ALL 2019 W-2 Statements. How many? (_____). Attach copies of ALL Tax Schedules from 2019.
Continue to STEP 5.
A. If NO, complete the table below and attach copies of ALL 2019 W-2 forms and a verification of Non-Filing letter from the IRS
dated on or after October 1, 2020). DO NOT LEAVE BLANK! Continue to STEP 4.
Source of Income (Fill out only if you did NOT file taxes)
Amount Earned In 2019
TOTAL
PLEASE NOTE: If you have not already done so, you may use the IRS Data Retrieval Tool from FAFSA.gov to transfer your tax
information to your FAFSA. To request a Federal Tax Return Transcript (NOT TAX ACCOUNT TRANSCRIPT) or a “W-2 Wage
Summary” (If you did not keep a copy of your W-2 form) you must call the IRS at (800) 908-9946. Please be advised that it may
take a minimum of three weeks for the IRS to mail these documents to you or you may also visit www.irs.gov, go to Get Your Tax
Record and follow the appropriate steps.
STEP 4 – STUDENT AND PARENT UNTAXED INCOME INFORMATION – DO NOT LEAVE BLANK!
If you and your parents received any sources of untaxed income please list the totals below. If an answer doesn’t apply
please list zero or list non-applicable.
2019 Untaxed Income
Student
Parent
Child support received for all children in the household
$
$
Cash receive or money paid on your behalf
$
$
Other untaxed income or benefits not reported elsewhere (workers comp, disability, clergy
allowances, etc.) Include Source
$
$
STEP 5 – CERTIFICATION: By signing this worksheet, I (we) certify all the information reported is complete and correct,
and I (we) understand that this worksheet is considered incomplete without the requested appropriate documentation:
Student Signature Date
(Handwritten signature only, electronic signature not acceptable)
Parent Signature (IF Student is dependent)/Spouse Signature (IF Student is married) Date
(Handwritten signature only, electronic signature not acceptable)
WARNING: If you purposely give false or misleading information you may be fined, be sentenced to jail, or both.
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Completed 1 February 2021

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