CALIFORNIA DREAM ACT DEPENDENT STUDENT VERIFICATION WORKSHEET ( )

Transcription

1 ANTELOPE VALLEY COLLEGE Financial Aid Office CALIFORNIA DREAM ACT DEPENDENT STUDENT VERIFICATION WORKSHEET ( ) Your California Dream Act application was selected for review in a process called verification. What you should do: Fill out all sections of this form and return it to the financial aid office. Submit all other required documents to the financial aid office. Complete this process as soon as possible so that your financial aid will not be delayed. If you have any questions about filling out this worksheet, please speak with someone in the financial aid office. Your financial aid technician will compare information on this worksheet and any supporting documents with the information you submitted on your application. Corrections may need to be made to your application. Student Information (COMPLETE IN BLACK INK ONLY) NAME: AVC ID #: DATE OF BIRTH: TELEPHONE NUMBER: A. Household Information List below the people in your parent(s) household, Include: Yourself and your parent(s) (including stepparent) even if you don t live with your parent(s). Dependent children if your parent(s) will provide more than half of their support from July 1, 2016, through June 30, Children who are eligible to complete a financial aid application for , even if they do not live with your parents, and would be required to provide parental information. 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, Include the name of the college for any family member listed, excluding your parent(s), who will be attending at least half time between July 1, 2016 and June 30, Full Name Age Relationship To Student Name of College (if half-time attendance or more during )

2 Student s Name: Student s ID Number: Page 2 of 4 B. Student s Income Information TAX RETURN FILERS- Complete this section if you filed or were required to file 2015 income tax returns. If you need help ordering your IRS Tax Transcript please see How to order an IRS Tax Return Transcript at the end of this document. I have attached my 2015 IRS Tax Transcript I, the student did not earn wages in NON-TAX RETURN FILERS- Complete this section if you will not and are not required to file 2015 income tax returns. Check the box that applies: I, the student was not employed and had no income earned from work in I, the student was employed in 2015 and have listed below the names of all employers, and the wages earned from each employer in Attach copies of all 2015 IRS W-2 forms issued to you by employer. List every employer even if they did not issue an IRS W-2 form. Employer s Name 2015 Wages C. Parent s Income Information- Note: If two parents were reported in Section A of this worksheet, the instructions and certifications below refer and apply to both parents. TAX RETURN FILERS- Complete this section if the student s parent(s) filed or were required to file 2015 income tax returns. If you need help ordering your IRS Tax Transcript please see How to order an IRS Tax Return Transcript at the end of this document IRS tax return transcript. Check the box that applies: Parent s Joint 2015 IRS Tax Transcript Father/Stepfather 2015 IRS Tax Transcript Mother/Stepmother 2015 IRS Tax Transcript

3 Student s Name: Student s ID Number: Page 3 of 4 If the student s parents filed an amended 2015 IRS tax return, attach a copy of the IRS tax return transcript and IRS account transcript. The parent(s) have earned wages in 2015 The parent(s) did not earn wages in NON-TAX RETURN FILERS- Complete this section if the student s parent(s) will not and are not required to file 2015 income tax returns. Check the box that applies: The parent(s) was not employed and had no income earned from work in The parent(s) was employed in 2015 and has listed below the names of all the parent s employers, and the amount earned from each employer in Attach copies of all 2014 IRS W-2 forms issued to the parent(s) by employer(s). List every employer even if they did not issue an IRS W-2 form. Employer s Name 2015 Wages D. Untaxed Income and Benefits Did you and/or someone listed in the household in Section A of this worksheet, pay child support in 2015? Yes No If yes, complete the section below. Please indicate below the name of the person who paid the child support, the name of the person to whom the child support was paid, the names of the children for whom child support was paid, and the total annual amount of child support that was paid in 2015 for each child. If asked by the school, I will provide documentation of the payment of child support. (Do not include support for children included in household size in Section A) Name of Person Who Paid Child Support Name of Person to Whom Child Support was Paid Name of Child for Whom Support was Paid Age of Child Amount of Child Support Paid in 2015

4 Student s Name: Student s ID Number: Page 4 of 4 Note: If we have reason to believe that the information regarding child support paid is not accurate, we may require additional documentation, such as: A copy of the separation agreement or divorce decree that shows the amount of child support to be provided; A statement from the individual receiving the child support certifying the amount of child support received; or Copies of the child support payment checks or money order receipts. Did you or someone in your household, receive benefits from the Supplemental Nutrition Assistance Program or SNAP (formerly known as food stamps) any time during the 2014 or 2015 years? Yes No E. Certification and Signatures By signing this worksheet, I/we certify that all the information is complete and correct. The student and at least one parent must sign and date to be valid. If required signatures are missing this form is considered incomplete. WARNING Certification Statement: By signing this document, you certify that the information you submit is true. If you purposely give false or misleading information, you may be sent to prison, fined 20, or both. Signature of Applicant Date Signature of Parent Date Submit this worksheet to: Antelope Valley College Financial Aid Office

5 HOW TO ORDER AN IRS TAX RETURN TRANSCRIPT To obtain a free IRS tax return transcript: 1. Go to and click on the Get Transcript of Your Tax Records link under Tools. If you create an account before proceeding to the additional steps of requesting a tax transcript, you should be able to request the transcript be mailed to your address on record. 2. Alternatively, you may call , or 3. Contact your local IRS office to see if you may pick up a copy. Make sure to request the IRS tax return transcript and not the IRS tax account transcript. You will need the Social Security Number (or the IRS individual taxpayer identification number) and date of birth of the first person listed on the 2015 IRS income tax return, and the address on file with the IRS (normally this will be the address used when the 2015 tax return was filed). Adequate time from the date of filing your tax return (up to three weeks for IRS electronic filers, and up to eleven weeks for paper IRS filers) is necessary prior to requesting an IRS tax return transcript.