Sage Verification Form (V5)

Transcription

1 PO Box 4108, Flagstaff, AZ nau.edu/osfa A. Student Information Student Name: Phone: Sage Verification Form (V5) 7-digit NAU ID Number: NAU Your Free Application for Federal Student Aid (FAFSA) was selected by the Department of Education for review in a federal process called Verification. In this process, the Office of Scholarships and Financial Aid (OSFA) will compare your FAFSA with the information on this form and on any other documents requested now or throughout the review process. Federal law requires us to complete this process before awarding or disbursing federal aid. If there are differences between your FAFSA and verification documents, we will make the corrections electronically and adjust aid as necessary. If you have questions about this process, go to: nau.edu/verification Instructions: Complete this form in its entirety. Answer all questions. If the situation does not apply to you, your parents (if dependent) and/or your spouse (if applicable), enter 0 or N/A. Incomplete forms cannot be accepted and will delay processing. Submit the original form to OSFA via mail or in-person. ed or faxed forms cannot be accepted. B. Family Information (attach additional pages if necessary) Dependent Students Independent Students List everyone in your parents household, including: Yourself Your parents (including a stepparent) Your parents other children, even if they don t live with your parents, if your parents will provide more than half of their support from July 1, 2019 through June 30, Other people, if they now live with your parents, and your parents provide more than half of their support and will continue to provide that support from July 1, 2019 through June 30, List the college name for any household member, excluding your parents, who will be enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary educational institution any time between July 1, 2019 and June 30, List everyone in your household, including: Yourself Your spouse, if married Your children, even if they do not live with you, if you will provide more than half of their support from July 1, 2019 through June 30, Other people, if they now live with you, and you provide more than half of their support and will continue to provide that support from July 1, 2019 through June 30, List the college name for any household member who will be enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary educational institution any time between July 1, 2019 and June 30, Full Names of all People in Household Age Relationship College Attending Self (student) Northern Arizona University

2 C. Student Tax Forms and Income Information (include spouse, if applicable) 1. For 2017, did you, the student, and your spouse (if applicable) complete a federal IRS income tax return? As of the date I filed the FAFSA, I: was married was not married. I/we completed a 2017 return & the tax return transcript or signed tax return copy is attached. skip to C3 No tax return transcript is required if the IRS Data Retrieval Tool was used on the FAFSA, and no IRS fields were manually changed. I/we will file but have not yet completed a 2017 return. skip to C3 Attach all W-2s, 4868 Tax Extension Form, & an un-expired IRS approval of extension. I/we will not file because I am/we are not required to do so. proceed to C2 Dependent students: Complete all fields in sections C2 & C3. Independent students: Complete all fields in sections C2 & C3 AND attach a Verification of Non-Filing Letter 2. If you and/or your spouse were paid for work in 2017 but did not file and are not required to file a 2017 Federal IRS income tax return, list the employers/sources of income and the amounts of all in Attach a separate page if necessary. If this situation does not apply to you, enter 0 or N/A in all fields. Attach W2s for all employers/sources listed. Student information Spouse information (if applicable) 3. Did you and/or your spouse have untaxed income from either of the following on your 2017 federal tax return? IRA Distribution: No Yes -- Rollover amount, if any: Pension: No Yes -- Rollover amount, if any: D. Parent Tax Forms and Income Information (Dependent students only) 1. For 2017, did your parent (and their spouse), complete a federal IRS income tax return? They filed a 2017 return & the tax return transcript or signed tax return copy is attached. skip to D3 No tax return transcript is required if the IRS Data Retrieval Tool was used on the FAFSA and no IRS fields were manually changed. They will file but have not yet completed a 2017 return. skip to D3 Attach all W-2s, 4868 Tax Extension Form, & an un-expired IRS approval of extension. They will not file because they are not required to do so. proceed to D2 Complete all fields in section D2 and D3 AND attach a Verification of Non-Filing Letter for each parent & stepparent. Page 2 of 5 Revised: 1/2019

3 2. If your parent(s), were paid for work in 2017 but did not file and are not required to file a 2017 federal IRS income tax return, list the employers/sources of income and the amounts of all in Attach a separate page if necessary. If this situation does not apply, enter 0 or N/A in all fields. Attach W2s for all employers/sources listed. Parent information 3. Did your parent(s) have untaxed income from either of the following on their 2017 federal tax return? IRA Distribution: No Yes -- Rollover amount, if any: Pension: No Yes -- Rollover amount, if any: E. Identity and Statement of Educational Purpose (to be signed at the Institution) The student must appear in person at Northern Arizona University to verify his or her identity by presenting an unexpired valid government-issued photo identification (ID), such as, but not limited to a driver s license, other state-issued ID, or passport. (Note: If unable to attend in person, skip to section F and sign in the presence of a Notary Public.) The institution will maintain a copy of the student s photo ID that is annotated by the institution with the date it was received and reviewed, and the name of the official at the institution authorized to receive and review the student s ID. In addition, the student must sign, in the presence of the institutional official, the Statement of Educational Purpose provided below. I certify that I,, am the individual signing this Statement of Educational Purpose and that the federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending Northern Arizona University for Student s Signature Page 3 of 5 Revised: 1/2019

4 F. Identity and Statement of Educational Purpose (to be signed in the presence of a notary) If the student is unable to appear in person at Northern Arizona University to verify his or her identity, the student must provide the institution both of the following items: 1. A legible copy of the unexpired valid government-issued photo identification that is acknowledged in the notary statement below, or that is presented to a notary, such as, but not limited to a driver s license, other state-issued ID, or passport; and 2. The original Statement of Educational Purpose provided below, which must be notarized. If the notary statement appears on a separate page other than the Statement of Educational Purpose, there must be a clear indication that the Statement of Educational Purpose was the document notarized. I certify that I,, am the individual signing this Statement of Educational Purpose and that the federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending Northern Arizona University for Student s Signature Notary s Certificate of Acknowledgement: State of City/County of On, before me,, Notary name personally appeared,, and proved to me on the basis of Printed name of signer satisfactory evidence of identification,, Type of unexpired government-issued photo ID provided to be the above-named person who signed the foregoing instrument. WITNESS my hand and official seal seal Notary signature My commission expires on. Page 4 of 5 Revised: 1/2019

5 G. Agreement and Understanding By signing this form, you certify that all of the information reported on this form is true and accurate to the best of your knowledge. If requested, you agree to provide proof of the information that you have reported on this form. If you purposely give false or misleading information on your FAFSA or on this form, you may be fined, sentenced to jail, or both (20 U.S. Code 1097). Important: Review this form before signing to confirm all fields have been completed. If a situation does not apply to you, enter 0 or N/A. Incomplete forms will not be processed and will be shredded for security purposes. Typed or electronic signatures cannot be accepted. Student Signature: Parent Signature: : : Page 5 of 5 Revised: 1/2019