Verification Worksheet- V5 DIRECTIONS 2015 INCOME TAX FILER DIRECTIONS:

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1 DIRECTIONS 2015 INCOME NEW: Beginning with the FAFSA, families are required to report income information from an earlier tax year. For example, on the FAFSA, students (and parents, as appropriate) have to report their 2015 income information, rather than their 2016 income information. Your application was selected by the U.S. Dept. of Education for review in a process called "verification". You must submit the last 4 pages of this verification worksheet, provide IRS Income Verification from 2015 (2015 IRS Tax Return Transcript or 2015 IRS Tax Return Signed (1040, 1040A, 1040EZ), along with 2015 W2s (non-tax-filers only). IRS Income Verification: Tax filers directions are on page 1 Submit 2015 IRS Tax Return Transcript OR 2015 IRS Tax Return Signed (1040, 1040A, 1040EZ). Special Circumstances directions are on page 2 Examples: 2015 Active Tax Extensions, Identity Theft, 2015 Amended Returns, Foreign Tax Returns and IRA Rollovers and Pension Rollovers w/ IRS DRT Non-tax filers Submit copies of all 2015 W2s or equivalent TAX FILER DIRECTIONS: IRS INCOME VERIFICATION 2015 TAX YEAR: The most efficient way to verify income is by using the IRS Data Retrieval Tool within your FAFSA application. If the student/parent has not already used the tool, then please follow the directions below (IRS Data Retrieval is currently not available at this time). o For families with special circumstances, such as filing tax extensions (Form 4868), victims of identity theft, amended tax return filers (1040X), or IRA Rollovers and Pension Rollovers with IRS DRT, please see the section on special circumstances on page 2. IRS TAX RETURN TRANSCRIPT or IRS TAX RETURN - SIGNED (1040, 1040A, 1040EZ) 2015 TAX YEAR: If you did not use the IRS Data Retrieval tool, all tax filers must submit a 2015 IRS Tax Return Transcript or 2015 IRS Tax Return Signed (1040, 1040A, 1040EZ). (IRS Data Retrieval is currently not available at this time). You can obtain a Tax Return Transcript by using one of the following: Online Request - Go to click "Get Transcript by Online" or Get Transcript by Mail. Be sure to request the IRS Tax Return Transcript and Tax Year NOT the IRS Tax Account Transcript. IRS2Go App download the app at the following to request a transcript: Apple Online Store at Google Play at Telephone Request Call to request a 2015 IRS Tax Return Transcript. Paper Request Form - IRS Form 4506T-EZ or IRS Form 4506-T on for Tax Year 2015 DIRECTIONS PAGE 1

2 DIRECTIONS 2015 INCOME SPECIAL CIRCUMSTANCES DIRECTIONS: IRS INCOME VERIFICATION 2015 TAX YEAR: o Tax Extension o Form 4868 that was filed with the IRS -(signed) o Copy of the IRS approval of the extension beyond the 6 month extensiono W-2 Form(s) in 2015 or if self-employed, a signed statement certifying the 2015 AGI and tax paid. o Verification of Non-filing Letter (confirmation that the tax return has not yet been filed) from the IRS or other relevant tax authority dated on or after October 1, 2016 o IRS VERIFICATION OF NON-FILING LETTER 2015 TAX YEAR: Online Request - Go to click "Get Transcript by Online" or Get Transcript by Mail. Be sure to request the Verification of Non-filing Letter for Tax Year IRS2Go App download the app at the following to request a transcript of IRS Verification of Nonfiling Letter Apple Online Store at Google Play at Telephone Request Call to request an IRS Verification of Non-filing Letter and then enter "2015". Paper Request Form - IRS Form 4506T-EZ or IRS Form 4506-T on o Identity Theft o Tax Return Database View (TRDBV) Transcript - obtained from the IRS by calling o Statement signed and dated by the tax filer indicating that they were victims of IRS Tax-related identity theft and that the IRS has been made of aware of the tax-related identity theft. o Amended Returns o IRS Form 1040X (signed) o IRS Tax Return Transcript that includes information from the original OR any other IRS Transcript that includes all income and tax information from the original tax return or an IRS Tax Return Signed (1040, 1040A, 1040EZ) o Foreign Tax Returns/Puerto Rico, Northern Mariana Islands, Guam, American Samoa, or U.S. Virgin Islands Tax Returns o Transcript from relevant taxing authority listing tax account information for the tax year, if transcript can be obtained at no cost. Otherwise, a copy of tax return filed with taxing authority. o IRA Rollers and Pension Rollovers with IRS DRT The IRS DRT does not exclude tax return IRA and/or Pension Distribution Rollovers from untaxed income. This means the IRS DRT will include an IRA and/or Pension Distribution Rollover in your untaxed income on the FAFSA. This may result in a higher Expected Family Contribution (EFC) and decrease in your financial need. Do not attempt to correct the information yourself. By changing any of the tax data, you compromise the data transferred from the IRS. Provide the following to if you do have an Untaxed IRA and/or Pension Rollover: o A written notice/request for correction to your FAFSA Untaxed IRA and/or Pension Rollover; o A copy of Page 1 of your Federal 2015 IRS Federal Income Tax Return; o A copy of IRS Form 1099-R for all IRA or Pension distributions. DIRECTIONS PAGE 2

3 A. STUDENT VERIFICATION: Student s Last Name Student s First Name Student s M.I. Student s ID Number Student s Street Address (include apt. no.) Student s Date of Birth City State Zip Code Student s Address Student s Home Phone Number (include area code) Student s Alternate or Cell Phone Number B. FAMILY HOUSEHOLD VERIFICATION: If you are a dependent student: Include yourself. Include your parent(s): o If your parents are divorced, list the parent you lived with the most during the last 12 months. If you did not live with one parent more than the other, indicate the parent who provided more than half of your support during the last twelve months. o If your parent is remarried, include step-parent. o If your parents are unmarried but live together, list Parent #1 and Parent #2. Include any other children of your parent(s), if your parents provide more than half of their support between July 1, 2017 and June 30, 2018 or if the children would be required to provide parental information if they were completing a FAFSA. Include other dependents, if they now live with your parent(s) and your parent(s) will continue to provide more than half of their support through June 30, If you are an independent student: Include yourself. Include your spouse, if you are married. Include your children or your spouse s children if you or your spouse will provide more than half of their support between July 1, 2017 and June 30, 2018, even if the children do not live with you. Include other dependents, if they now live with you and you or your spouse will continue to provide more than half of their support through June 30, Full Name: Write first and last name of household member. Age: Write the age of each family member in the chart below. Relationship: Write the Relationship of each family member to the student in the chart below. College: Add the name of the college for any household member who will be enrolled in a degree, diploma, or certificate program at an eligible postsecondary educational institution at least half-time any time between July 1, 2017 and June 30, 2018, excluding your parents. Full Name Age Relationship College attending in Self Sacred Heart University Will be Enrolled at Least Half Time (Yes or No) 1

4 C. INCOME VERIFICATION: TAX RETURN FILERS - If you do not or cannot use the IRS Data Retrieval tool, all tax filers must submit a 2015 IRS Tax Return Transcript or 2015 IRS Tax Return Signed (1040, 1040A, 1040EZ). NON-FILERS - Complete this section if the student/parent will not file and is not required to file a 2015 income tax return with the IRS. List below source(s) and ALL income received in 2015 Submit W-2 forms. If student or parent earned cash only, no W-2 form is required (however indicate cash then). Use another worksheet if needed. Complete the chart below: Check the box(es) for those people who did not and are not required to file a 2015 Federal Tax Return. You Your Father Your Mother Source of Income/Support Student Amount Father Amount Mother Amount o Note: Individuals who submit W-2s that total a gross income that equals or exceeds the IRS tax filing threshold must file an income tax return before the student is eligible to receive Title IV aid. These Individuals may have to then request a Social Security Number, an Individual Taxpayer Identification Number, or an Employer Identification Number. 2

5 D. HIGH SCHOOL COMPLETION STATUS VERIFICATION: Verification Worksheet- V5 A component of your verification requires that Sacred Heart University confirm that you have completed high school. Please provide one of the following documents confirming that you have completed high school. If you have not yet completed high school, but will complete high school before you begin Sacred Heart University, only return this form after you have completed high school. Check one: Attached is a copy of my high school diploma Attached is a copy of my final official high school transcript, showing the date that my high school diploma was awarded. Attached is a copy of my General Education Development (GED) certificate or GED transcript. Attached is an academic transcript indicating that I successfully completed at least a two-year program that is acceptable for full credit toward a bachelor s degree. I was homeschooled and my state law requires a student to obtain a secondary school completion credential. Attached is a copy of that credential. I was homeschooled and my state law does not require a homeschooled student to obtain a secondary school completion credential. Attached is a transcript or the equivalent, signed by my parent or guardian, that lists the secondary schools courses I completed and documents the successful completion of a secondary school education in a homeschooled setting. E. CERTIFICATION AND SIGNATURES VERIFICATION: Each person signing this worksheet certifies that all of the information reported on it is complete and correct. The student and one parent must sign and date. WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both. Note: if any information on this form is left blank it will be considered zero or not applicable. Student s Signature Date Parent s or Spouse s Signature Date If there are differences between your application and the documents you've submitted, corrections may be needed. We cannot process your federal aid until verification has been completed. Please provide the required documentation within 15 days of starting school or the start of your next academic year as applicable. 3

6 H. IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE: Verification Worksheet- V5 THE STUDENT MUST APPEAR IN PERSON AT SACRED HEART 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. 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 following: IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE I certify that I am the individual signing this (Print Student s Name) 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 Sacred Heart University for (Student s Signature) (Student s ID Number) The above statement must be signed in the presence of a notary if the student is unable to appear in person at Sacred Heart University to verify his or her identity; the student must provide: (a) a copy of an unexpired valid government-issued photo identification (ID) that is acknowledged in the notary statement below, such as but not limited to a driver s license, other state-issued ID, or passport; and (b) The original notarized Statement of Educational Purpose provided below. Notary s Certificate of Acknowledgement State of City/County of On, before me,, (Notary s name) personally appeared,, and provided to me on basis of satisfactory evidence (Printed name of signer) of identification to be the above-named person who signed the foregoing instrument. WITNESS my hand and official seal (Notary signature) (seal) My commission expires on Please submit the last 4 pages of this Verification Worksheet, along with your Tax Transcripts (tax filers only-if applicable), IRS Verification of Non-filing Letter (non-tax filers only) and W2s (non-tax filers only) to: This document contains personally identifiable information, our office will only accept documents via regular mail, secure fax or in person. Submit this worksheet to the Student Financial Assistance Office 5151 Park Avenue, Fairfield, CT (phone) (secure fax) 4

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