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– Verification Worksheet
Dependent Student

Your form contains errors. Please review the form and correct errors before attempting to print!  

Your – 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. Failure to submit the required forms within 60 days may result in your financial aid application being denied.If you have questions about verification, contact your financial aid administrator as soon as possible so that your financial aid will not be delayed.

Student Information

Demographic Information

Household Information

Indicate the parents' marital status.
 

List below the people in your parent(s) household. Include:
  • The student
  • The parents (including a stepparent) even if the student doesn't live with the parents.
  • The parents’ other children if the parents will provide more than half of the children’s support from July 1, , through June 30, , or if the other children would be required to provide parental information if they were completing a FAFSA for –. Include children who meet either of these standards even if the children do not live with the parents.
  • Other people if they now live with the parents and the parents provide 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, .
 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.

Student Income Information

Did the student file a  income tax return with the IRS?

Important Note: The instructions below apply to the student.

Instructions: Complete this section if the student filed or will file a  IRS income tax return(s). 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  income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.

Check the box that applies:

 A  IRS Tax Return Transcript may be obtained through:

In most cases, for electronic tax return filers,  IRS income tax return information is available for the IRS DRT or the IRS Tax Return Transcript within 2–3 weeks after the  electronic IRS income tax return has been accepted by the IRS. Generally, for filers of  paper IRS income tax returns, the  IRS income tax return information is available for the IRS DRT or the IRS Tax Return Transcript within 6–8 weeks after the  paper IRS income tax return has been received by the IRS. Contact the financial aid office if more information is needed about using the IRS DRT or obtaining an IRS Tax Return Transcript.

The instructions below apply to the student. Complete this section if the student will not file and is not required to file a  income tax return with the IRS.

Check the box that applies:
 Note: We may require you to provide documentation from the IRS that indicates a  IRS income tax return was not filed with the IRS.

Other Untaxed Income

To determine the correct annual amount for each item: If you paid or received the same dollar amount every month in  , multiply that amount by the number of months in   you paid or received it. If you did not pay or receive the same amount each month in  , add together the amounts you paid or received each month.

Student Untaxed Income

A. Payments to tax-deferred pension and retirement savings

List any payments (direct or withheld from earnings) to tax-deferred pension and retirement savings plans (e.g., 401(k) or 403(b) plans), including, but not limited to, amounts reported on W-2 forms in Boxes 12a through 12d with codes D, E, F, G, H, and S.

B. Child Support Received

List the actual amount of any child support received in  for the children in your household. Do not include foster care payments, adoption payments, or any amount that was court-ordered but not actually paid.

C. Housing, food, and other living allowances paid to members of the military, clergy, and others

Include cash payments and/or the cash value of benefits received. Do not include the value of on-base military housing or the value of a basic military allowance for housing.

D. Veterans Non-Education Benefits

List the total amount of veterans non-education benefits received in . Include Disability, Death Pension, Dependency and Indemnity Compensation (DIC), and/or VA Educational Work-Study allowances. Do not include federal veterans educational benefits such as: Montgomery GI Bill, Dependents Education Assistance Program, VEAP Benefits, Post-9/11 GI Bill.

E. Other Untaxed Income

List the amount of other untaxed income not reported and not excluded elsewhere on this form. Include untaxed income such as workers’ compensation, disability, Black Lung Benefits, untaxed portions of health savings accounts from IRS Form 1040 Line 25, Railroad Retirement Benefits, etc. Do not include any items reported or excluded in A – D above. In addition, do not include extended foster care benefits, student aid, Earned Income Credit, Additional Child Tax Credit, Temporary Assistance to Needy Families (TANF), untaxed Social Security benefits, Supplemental Security Income (SSI), Workforce Innovation and Opportunity Act (WIOA) educational benefits, on-base military housing or a military housing allowance, combat pay, benefits from flexible spending arrangements (e.g., cafeteria plans), foreign income exclusion, or credit for federal tax on special fuels.

F. Money Received or Paid on Student's Behalf

List any money received or paid on the student’s behalf (e.g., payment of student’s bills) and not reported elsewhere on this form. Enter the total amount of cash support the student received in . Include support from a parent whose information was not reported on the student’s – FAFSA, but do not include support from a parent whose information was reported. For example, if someone is paying rent, utility bills, etc., for the student or gives cash, gift cards, etc., include the amount of that person's contributions unless the person is the student’s parent whose information is reported on the student’s – FAFSA. Amounts paid on the student’s behalf also include any distributions to the student from a 529 plan owned by someone other than the student or the student’s parents, such as grandparents, aunts, and uncles of the student.

Additional Information

Provide information about any other resources, benefits, and other amounts received by the student and any members of the student’s household. This may include items that were not required to be reported on the FAFSA or other forms submitted to the financial aid office, and includes such things as federal veterans’ education benefits, military housing, SNAP, TANF, etc.

Parent Income Information

Did any parent file a  income tax return with the IRS?

Important Note: The instructions below apply to each parent included in the household. Notify the financial aid office if the parents filed separate IRS income tax returns for  or had a change in marital status after December 31, .

Instructions: Complete this section if the parents filed or will file a  IRS income tax return(s). 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  income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.

Check the box that applies:

 A  IRS Tax Return Transcript may be obtained through:

In most cases, for electronic tax return filers,  IRS income tax return information is available for the IRS DRT or the IRS Tax Return Transcript within 2–3 weeks after the  electronic IRS income tax return has been accepted by the IRS. Generally, for filers of  paper IRS income tax returns, the  IRS income tax return information is available for the IRS DRT or the IRS Tax Return Transcript within 6–8 weeks after the  paper IRS income tax return has been received by the IRS. Contact the financial aid office if more information is needed about using the IRS DRT or obtaining an IRS Tax Return Transcript.

If the parents filed separate  IRS income tax returns, the IRS DRT cannot be used and the  IRS Tax Return Transcript(s) must be provided for each

The instructions and certifications below apply to each parent included in the household. Complete this section if the parents will not file and are not required to file a  income tax return with the IRS.

Check the box that applies:
 Note: We may require you to provide documentation from the IRS that indicates a  IRS income tax return was not filed with the IRS.

Other Untaxed Income

To determine the correct annual amount for each item: If you paid or received the same dollar amount every month in  , multiply that amount by the number of months in   you paid or received it. If you did not pay or receive the same amount each month in  , add together the amounts you paid or received each month.

Parent Untaxed Income

A. Payments to tax-deferred pension and retirement savings

List any payments (direct or withheld from earnings) to tax-deferred pension and retirement savings plans (e.g., 401(k) or 403(b) plans), including, but not limited to, amounts reported on W-2 forms in Boxes 12a through 12d with codes D, E, F, G, H, and S.

B. Child Support Received

List the actual amount of any child support received in  for the children in your household.Do not include foster care payments, adoption payments, or any amount that was court-ordered but not actually paid.

C. Housing, food, and other living allowances paid to members of the military, clergy, and others

Include cash payments and/or the cash value of benefits received. Do not include the value of on-base military housing or the value of a basic military allowance for housing.

D. Veterans Non-Education Benefits

List the total amount of veterans non-education benefits received in . Include Disability, Death Pension, Dependency and Indemnity Compensation (DIC), and/or VA Educational Work-Study allowances. Do not include federal veterans educational benefits such as: Montgomery GI Bill, Dependents Education Assistance Program, VEAP Benefits, Post-9/11 GI Bill.

E. Other Untaxed Income

List the amount of other untaxed income not reported and not excluded elsewhere on this form. Include untaxed income such as workers’ compensation, disability, Black Lung Benefits, untaxed portions of health savings accounts from IRS Form 1040 Line 25, Railroad Retirement Benefits, etc. Do not include any items reported or excluded in A – D above. In addition, do not include extended foster care benefits, student aid, Earned Income Credit, Additional Child Tax Credit, Temporary Assistance to Needy Families (TANF), untaxed Social Security benefits, Supplemental Security Income (SSI), Workforce Innovation and Opportunity Act (WIOA) educational benefits, on-base military housing or a military housing allowance, combat pay, benefits from flexible spending arrangements (e.g., cafeteria plans), foreign income exclusion, or credit for federal tax on special fuels.

Additional Information

Provide information about any other resources, benefits, and other amounts received by the parents and any members of the parents’ household. This may include items that were not required to be reported on the FAFSA or other forms submitted to the financial aid office, and includes such things as federal veterans’ education benefits, military housing, SNAP, TANF, etc.

Parent SNAP Information

Verify if a member of the parents' household received benefits from the Supplemental Nutrition Assistance Program (SNAP) sometime during  or  . SNAP may be known by another name in some states. For assistance in determining the name used in a state, please call 1-800-4FED-AID (1-800-433-3243).

The parents' household includes:

  • The student.
  • The parents (including a stepparent) even if the student doesn’t live with the parents.
  • The parents’ other children if the parents will provide more than half of the children’s support from July 1, , through June 30, , or if the other children would be required to provide parental information if they were completing a FAFSA for –. Include children who meet either of these standards even if the children do not live with the parents.
  • Other people if they now live with the parents and the parents provide more than half of the other person's support and will continue to provide more than half of the other person's support through June 30, .

Note: If we have reason to believe that the information regarding the receipt of SNAP benefits is inaccurate, we may require documentation from the agency that issued the SNAP benefits in  or  .
Did anyone in the parents' household receive SNAP benefits?

Parent Child Support

Did one or both of the student’s parents pay child support in ?

Provide in the space below the names of the persons who paid the child support, the names of the persons to whom the child support was paid, the names and ages of the children for whom the child support was paid, and the total annual amount of child support that was paid in  for each child.

Note: If we have reason to believe that the information regarding child support paid is inaccurate, we may require additional documentation, such as:
  • A signed statement from the individual receiving the child support certifying the amount of child support received; or,
  • Copies of the child support payment checks, money order receipts, or similar records of electronic payments having been made.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.

By submitting this electronic form, I certify all of the information reported is complete and correct.

Once you have completed all tabs on this form click Print to Continue and then Submit.

Please sign the printed copy and send to the Financial Aid Office.

Dropped Off: Financial Aid Office Room 105, SC4 Welcome Center Faxed: (810) 989-5774 Mailed: SC4 Financial Aid 323 Erie St. PO Box 5015 Port Huron, MI 48061-5015

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