I affirm that I have read, understood, and agreed to this form in its entirety and that the information supplied is true and complete.

Transcription

1 Office of Financial Aid and Scholarships Student Success Building Counter #6 Campus Box 2, PO Box Denver, CO Phone Number: Institutional Verification INDEPENDENT Name: Date of Birth: 900#: Phone Number: I affirm that I have read, understood, and agreed to this form in its entirety and that the information supplied is true and complete. Signature: Date: Your financial aid application has been selected for verification by the US Department of Education. We are required by Federal regulation to collect this form and associated documentation before you can receive any federal or state aid. Partial or incomplete documents will NOT be accepted. This form MUST be received by our office at least 3 weeks prior to the end of the semester that you are requesting financial aid consideration for. Form Requirements: Please fill out form, and sign legibly in blue or black ink. A computer generated, or electronic signature will not be accepted. Answer all the questions on this form, if the answer is zero or not applicable, enter 0. If you successfully completed the Data Retrieval Match utilizing the IRS Data Retrieval Tool when completing your FAFSA and have made no changes, you do not need to provide tax return transcripts. Income Verification There are 2 ways to request a Federal Tax Return Transcript: phone, or online, Transcripts are free! Allow up to 10 business days before you receive the tax transcript from the IRS. Important: Account Transcripts are NOT acceptable. I. MARITIAL STATUS: Single Married Separated/Divorced II. YOU MUST CHECK AND COMPLETE SECTION A, B, C, D, OR E. A. DID NOT WORK- Please submit a letter of non-filer from the IRS. Student Spouse B. DID WORK BUT DID NOT FILE 2016 FEDERAL INCOME TAX RETURN If you and/or your spouse were not required to file a 2016 Federal income tax return, provide all copies of your 2016 W2 s, as well as a non-filling letter, which you can obtained by contacting the IRS. Also list all sources of taxable income such as interest income and unemployment compensation received in Page 1 of 5

2 Student: Spouse: C. FILED 2016 TAX RETURNS Check appropriate box below and attach documents if required. Completed IRS DATA RETRIEVAL MATCH (tax return transcripts are not required for this option) Student Spouse DID NOT complete IRS Data Retrieval Match MUST ATTACH copies of 2016 Federal Return Transcripts Student Spouse D. If you and/or your spouse filed a tax extension that is valid beyond October 16, 2017, please provide the following documentation: IRS form 4868 Unexpired approval letter from the IRS A letter of non-filer from the IRS showing you have not yet filed ALL 2016 W2s E. Filed an Amended IRS Income Tax Return Provide a signed copy of the original 2016 IRS income tax return that was filed with the IRS or a 2016 Tax Return Transcript AND a signed copy of the 2016 IRS Form 1040X Amended US tax return that was filed with the IRS. Student Spouse III. TAXABLE FINANCIAL AID Did you or your spouse receive Federal or State need based work-study? Please provide a copy of your W2s. Did you or your spouse report grants/scholarships on your tax return? Please submit a copy of your 2016 federal Tax Return that states SCH on wages line. Page 2 of 5

3 Did you or your spouse report Education credits (American Opportunity, HOPE and Lifetime Learning Tax Credits) from IRS form 1040 line 50 or 1040A line 33? Please submit a copy of your 2016 federal Tax Return (1040, 1040A, 1040EZ) or 2016 Tax Return Transcript. IV. UNTAXED INCOME Did you file an IRA and/ or pensions and annuities as a rollover on your tax return? You can submit a copy of your Federal Tax Return please note that this does not preclude you from submitting the 2016 Federal Tax Return Transcript. We would need both the tax return and the tax return transcript. Rollovers are not documented on the Tax Return Transcript and including this can affect the amount of aid you may be eligible to receive. Yes No Household Verification Include in your household: Yourself Your children, if you will provide more than half of their support from July 1, 2018 through June 30, If you are paying child support, do not list that child in the household size. You should NOT report foster children. Spouse- if you and your spouse have different last names, you must submit a marriage certificate. Do not include roommates. Common Law Married If you and spouse consider yourselves to be common law married. Please provide: o Copy of your joint federal 2016 or 2017 tax return. OR provide the 3 items listed below: o Copy of your joint bank account statement (Please note: joint bank account must have been established prior to the date the FAFSA was filed.), o o lease agreement or mortgage statement with both names A statement from friend or family member stating that you and your spouse represent yourselves as married. Documentation of all requirements must be met to be considered common law married. Please note - We will make sure that you file a married joint federal tax return in future years as you will be legally married according to the court system. Other people- if they now live with you, you provide more than half of their support and you will continue to provide more than half of their support between July 1, 2018 and June 30, Documentation of support may be requested. Not providing this information will exclude this person from being included in the household size. Do not include roommates. Page 3 of 5

4 List household members Relationship (i.e. parent, brother, sister, etc.) Age Is family member in college and enrolled at least half time? If you have other family members in college, please list the college name and address. Enrollment will be verified. If your response is longer than space given, please attach an additional sheet of paper with your information. Child Support Paid: Did you/spouse pay child support for child(ren) not living in your household during 2016? Yes (Note you may be requested to submit documentation of the support paid) No Child(ren) s Name(s) Total Amount Paid in 2016 $ Child(ren) s Name(s) Total Amount Paid in 2016 $ Name of Person(s) to whom child support was paid to in 2016: Other People: If there are other people living in the household, you must provide documentation for those included. Please explain the extenuating circumstances as to why you are responsible for the individual and in what way you are supporting this person for: food, shelter, and health insurance. You are required to report any earnings or benefits the individual received. You must explain why adults are not receiving income. If you do not provide in your statement the amount of benefits received, we will incomplete this form. Page 4 of 5

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