Last Name First Name M.I. Social Security or Student ID Number. Permanent Home Address Street & Number City/State/Zip Date of Birth

Transcription

1 Verification Worksheet Household Resources Dependent Student Financial Services Phone: E. College Avenue North Manchester, Indiana Fax: 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 whose information is on the FAFSA must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to Student Financial Services. Manchester University may ask for additional information. If you have questions about verification, contact Student Financial Services as soon as possible so that your financial aid will not be delayed. V6 A. Dependent Student s Information Last Name First Name M.I. Social Security or Student ID Number Permanent Home Address Street & Number City/State/Zip of Birth Cell Phone Number (Include Area code) Home Phone Number (Include Area code) Address B. Dependent Student s Family Information List below the people in your parent(s) household. Include: Yourself and your parent(s) (including a stepparent) even if you don t live with your parent(s). Your parent(s) other children if your parent(s) will provide more than half of their support from July 1, 2016, through June 30, 2017, 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 they do not live with your parent(s). 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, Full Name Age Relationship Attending a college or university at least half time? (do not include parents) If yes, name of college or university (no initials) Missy Jones (example) 18 Sister Central University Self Manchester University Page 1 of 6

2 C. Dependent Student s Income Information to Be Verified Have you or will you be required to file a 2015 U.S. federal income tax return? Check one. YES, NO, I will/have completed the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2015 IRS income tax return information into my student FAFSA, and did not make any changes to this information. (Copies of IRS tax return transcripts are not required.) Continue to Section D. I have attached a copy of my 2015 IRS Tax Return Transcript. To obtain a Tax Return Transcript, go to Continue to Section D. I had no income earned from work in Continue to Section D. I have income earned from work and am not required to file a 2015 income tax return with the IRS. YOU ARE REQUIRED TO PROVIDE COPIES OF ALL W-2 FORMS. List every employer even if the employer did not issue an IRS W-2 form. Employer s Name 2015 Amount Earned IRS W-2 Provided? No W-2? Explain here. Suzy s Auto Body Shop (example) $2, Yes Was paid in cash D. Parent s Income Information to Be Verified Have you or will you be required to file a 2015 U.S. federal income tax return? Check one. YES, NO, I/We will/have completed the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2015 IRS income tax return information into my student s FAFSA, and did not make any changes to this information. (Copies of IRS tax return transcripts are not required.) I/We have attached a copy of my/our 2015 IRS Tax Return Transcript(s). To obtain a Tax Return Transcript, go to I/We had no income earned from work in I/We have income earned from work and are not required to file a 2015 income tax return with the IRS. YOU ARE REQUIRED TO PROVIDE COPIES OF ALL W-2 FORMS. List every employer even if the employer did not issue an IRS W-2 form. Employer s Name 2015 Amount Earned IRS W-2 Provided? No W-2? Explain here. Suzy s Auto Body Shop (example) $2, Yes Was paid in cash Page 2 of 6

3 E. Other Untaxed Income Information Calendar Year 2015 Report all applicable income information for the parent (s) and the student below for the calendar year If any item does not apply, enter N/A for Not Applicable where a response is requested, or enter 0 in an area where an amount is requested. To determine the correct annual amount for each item: If you paid or received the same dollar amount every month in 2015, multiply that amount by the number of months in 2015 you paid or received it. If you did not pay or receive the same amount each month in 2015, add together the amounts you paid or received each month. If more space is needed, provide a separate page with the student s name and ID number at the top. 1. 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. Name of Person Who Made the Payment Total Amount Paid in Child support received List the actual amount of any child support received in 2015 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. Name of Adult Who Received the Support Name of Child For Whom Support Was Received Amount of Child Support Received in 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. Type of Benefit Received Amount of Benefit Received in 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 veteran s educational benefits such as: Montgomery GI Bill, Dependents Education Assistance Program, VEAP Benefits, and Post-9/11 GI Bill Type of Veterans Non-education Benefit Amount of Benefit Received in 2015 Page 3 of 6

4 5. 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. V6 Type of Other Untaxed Income Amount of Other Untaxed Income Received in Money received or paid on the 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. Purpose: e.g., Cash, Rent, Books Amount Received in 2015 Source 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. If more space is needed, provide a separate page with the student s name and ID number at the top. Type of Financial Support Annual Amount of Financial Support Received in 2015 F. Certification and Signatures You and one parent whose information is on the FAFSA must read and sign this statement. I/we certify that all of the information provided on this form and on any attached documentation is accurate and complete. If I/we purposely give false or misleading information, I/We may be fined, sent to prison or both. Student s Signature Parent s Signature Page 4 of 6

5 Verification of SNAP Benefits Received Verification of Child Support Paid Dependent Student Financial Services Phone: E. College Avenue North Manchester, Indiana Fax: Completion of this section is required to verify if someone in the student s parent s household received benefits from the Supplemental Nutrition Assistance Program or SNAP (formerly known as food stamps) any time during the 2014 or 2015 calendar years. SNAP may be known by another name in some states. For assistance in determining the name used in a state, please call FED-AID ( ). Student Last Name Student First Name M.I. Social Security or Student ID Number A. Did you or a member of your parent s household receive SNAP in 2014 and/or 2015? The parents household includes: Yourself and your parent(s) (including a stepparent) even if you don t live with your parent(s). Your parent(s) other children if your parent(s) will provide more than half of their support from July 1, 2015, through June 30, 2016, 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 they do not live with your parent(s). 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, No. Continue to section B. Yes. Please complete the information below then continue to section B. Please complete the following information for the person in your household receiving SNAP benefits. If you are the one receiving benefits, please indicate self in Relationship to Student. Age Relationship to Student Street Address Phone Number City State Zip County 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 2014 or Page 5 of 6

6 Completion of this section is required to verify if one of the parents included in the household or the student paid child support in List 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 of the children for whom the child support was paid, and the total annual amount of child support that was paid in 2015 for each child. B. PARENT(S) IN HOUSEHOLD: Did you pay child support in 2015? No Yes. Please provide the following information: Name of Person Who Paid Child Support Name of Person to Whom Child Support was Paid Name and age of Child for Whom Support Was Paid Total Amount of Child Support Paid in 2015 Marty Jones Chris Smith (example) Terry Jones, 5 $6, V6 C. Certification and Signatures You and one parent whose information is on the FAFSA and the parent paying child support must read and sign this statement. I/we certify that all of the information provided on this form is accurate and complete. If I/we purposely give false or misleading information, I/We may be fined, sent to prison or both. Student s Signature Parent s Signature Signature of Parent Paying Child Support Page 6 of 6

7 Student Financial Services Phone: E. College Avenue North Manchester, Indiana Fax: HOW TO PROVIDE YOUR 2015 FEDERAL TAX RETURN INFORMATION Federal Tax Return Filers, student and parents, are required to provide 2015 federal tax return information by using the FAFSA IRS Data Retrieval Tool or by obtaining a 2015 IRS Tax Return Transcript. Below are the instructions for both processes. IRS Data Retrieval Tool: Instructions: The best way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA on the Web. If the student and/or parent have not already used the tool, go to log in to the student s FAFSA record, select Make FAFSA Corrections, and navigate to the Financial Information section of the form. From there, follow the instructions to determine if the student and parent(s) is eligible to use the IRS Data Retrieval Tool to transfer 2015 IRS income tax information into the student s FAFSA. It takes 2-3 weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and 8-11 weeks for paper IRS tax return filers. For assistance using the IRS Data Retrieval Tool choose the Help tab on the FAFSA.gov website. IRS Tax Return Transcript(s): This is NOT a photocopy of your 1040 federal income tax return. Please note if you filed a joint federal tax return, you will use the primary tax filer s information with all options. Also, the address on file with the IRS is normally the address used when the 2015 IRS tax return was filed. A 2015 IRS Tax Return Transcript may be obtained through: Online Request - Go to under the Tools heading on the IRS homepage, click "Get a Tax Transcript by Mail." Click Get Transcript by MAIL. Make sure to request the IRS Tax Return Transcript and NOT the IRS Tax Account Transcript. Telephone Request - Call the IRS at You must follow prompts to enter your Social Security number and the numbers in your street address. Select Option 2 to request a Return Transcript and the year is Paper Request Form - IRS Form 4506T-EZ or IRS Form 4506-T You can expect to receive a paper IRS Tax Return Transcript within 5 to 10 business days. For assistance using the web page click on Contact Us and choose Navigate IRS.gov or call