Verification Worksheet Federal Student Aid Programs

2015-2016 Verification Worksheet Federal Student Aid Programs DEPENDENT STUDENT Your 2015 2016 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 Brenau Financial Aid Staff 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 must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the Brenau Financial Aid Office. If you have questions about verification, contact the Financial Aid Office as soon as possible in order to avoid a delay in receiving your financial aid award. A. DEPENDENT STUDENT S INFORMATION V6 Stude t s treet Address (include apt. number) tude t s o ial e urit Number or Brenau ID tude t s Date of Birth City State Zip tude t s E ail Address tude t s Ho e Pho e Nu er i lude area ode tude t s Cell Pho e Nu er i lude area ode B. DEPENDENT STUDENT S FAMILY INFORMATION List below the people in your pare t s household. Include: Yourself and your parent(s) (including a stepparent) even if you do t li e ith our pare ts. Your parent(s other hildre if your parents will provide more than half of their support from July 1, 2015 through June 30, 2016, or if the children would be required to provide parental information if they were completing a FAFSA for 2015-2016. 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, 2016. Include the name of the college for any household member, excluding your parent(s), who will be enrolled, at least half time in a degree, diploma, or certificate program at a postsecondary educational institution any time between July 1, 2015, and June 30, 2016. If more space is needed, attach a separate page with the student s name and Social Security Number or Brenau student ID number at the top. FULL NAME AGE RELATIONSHIP COLLEGE WILL BE ENROLLED AT LEAST HALF TIME Missy Jones (example) 18 Sister Central University Yes Self NOTE: We may require additional documentation if we have reason to believe that the information regarding the household members enrolled in eligible postsecondary educational institutions is inaccurate. 1

C. DEPENDENT STUDENT S INCOME INFORMATION TO BE VERIFIED 1. TAX RETURN FILERS Important Note: If the student filed or will file an amended 2014 IRS tax return OR has been granted a filing extension OR was a victim of IRS Identity Theft OR filed or will file a non IRS income tax return, the student must contact the Brenau Financial Aid Office before completing this section. Instructions: Complete this section if the student filed or will file a 2014 income tax return with the IRS. The best way to verify income is by using the IRS Data Retrieval Tool that is available in FAFSA on the Web. If the student has not already used the tool, go to FAFSA.gov, log in to the stude t s FAF A re ord, sele t Make FAF A Corre tio s, a d a igate to the Fi a ial I for atio se tio of the for. From there, follow the instructions to determine if the student is eligible to use the IRS Data Retrieval Tool to transfer 2014 IRS income tax information i to the stude t s FAF A. It takes two to three weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and eight to eleven weeks for paper IRS tax return filers. If you need more information about when, or how to use the IRS Data Retrieval Tool please contact the Financial Aid Office. The student has used the IRS Data Retrieval Tool in FAFSA on the Web to retrieve and transfer 2014 IRS income information into the stude t s FAF A, either o the i itial FAF A or he aki g a orre tio to the FAF A. The Financial Aid Office will use the IRS i for atio that as tra sferred i to the stude t s FAF A to o plete the erifi atio pro ess. The student has not yet used the IRS Data Retrieval Tool in FAFSA on the Web, but will use the tool to retrieve and transfer 2014 IRS i o e i for atio i to the stude t s FAF A o e the stude t has filed a 4 IRS tax return. See instructions above for information on how to use the IRS Data Retrieval Tool. The Financial Aid Office cannot complete the verification process until the IRS information has been transferred into the FAFSA. The student is unable or chooses not to use the IRS Data Retrieval Tool in FAFSA on the Web, and the student will submit to the school a 2014 IRS tax return transcript. To obtain an IRS Tax Return Transcript, go to www.irs.gov, a d li k o Get Tra s ript of Your Ta Re ords, or call 1-800-908-9946. If requesting online, you may be able to print a pdf of your Tax Return Transcript immediately. Make sure hoose Ta Retur. You will need your Social Security Number, date of birth, and the address on file with the IRS (normally this will be the address used when the 2014 IRS tax return was filed). It takes two to three weeks for IRS income information to be available for electronic IRS tax return filers, and eight to eleven weeks for paper IRS tax return filers. Che k here if the stude t s 2014 IRS Tax Return Transcript is attached to this worksheet. Copies of IRS Tax Returns cannot be used to complete verification requirements. Che k here if the stude t s 2014 IRS Tax Return Transcript will be submitted to the Financial Aid Office later. Verification cannot be completed until the IRS Tax Return Transcript has been submitted to the Financial Aid Office. 2. TAX RETURN NONFILERS Complete this section if the student will not file and is not required to file a 2014 income tax return with the IRS. The student was not employed and had no income earned from work in 2014. The student was employed in 2014 a d has listed elo the a es of all the stude t s e plo ers and the amount earned from each employer in 2014. Attach copies of all 2014 IRS W-2 forms issued to the student by employers. List every employer even if they did not issue an IRS W-2 form. If ore spa e is eeded, atta h a separate page ith the stude t s a e a d o ial e urit Nu er or Brenau student ID number at the top. E plo er s Na e 2014 Amount Earned IRS W-2 Attached? uz s Auto Bod hop e a ple $2,000.00(example) Yes(example) NOTE: We may require you to provide documentation from the IRS that indicates a 2014 IRS income tax return was not filed with the IRS. 2

D. PARENT(S) INCOME INFORMATION TO BE VERIFIED 1. TAX RETURN FILERS Important Note: If the stude t s pare t s filed or ill file a amended 2014 IRS tax return OR were granted a filing extension OR were victims of IRS Identity Theft OR filed or will file a non IRS income tax return, the Brenau Financial Aid Office must be contacted before completing this section. Instructions: Co plete this se tio if the stude t s pare t s filed or will file a 2014 income tax return with the IRS. The best way to verify income is by using the IRS Data Retrieval Tool that is available in FAFSA on the Web. If the stude t s pare t s has ot alread used the tool, the parent and the student should go to FAFSA.gov, log i to the stude t s FAF A re ord, sele t Make FAF A Corre tio s, a d a igate to the Financial Information section of the form. From there, follow the instructions to determine if the parent(s) is eligible to use the IRS Data Retrieval Tool to transfer 2014 IR i o e ta i for atio i to the stude t s FAF A. It takes two to three weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and eight to eleven weeks for paper IRS tax return filers. If you need more information about whether or how to use the IRS Data Retrieval Tool please contact the Financial Aid Office. The stude t s pare t has used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2014 IRS income information into the stude t s FAF A, either o the i itial FAF A or he aki g a orre tio to the FAF A. The Financial Aid Office will use the IRS i for atio tra sferred i to the stude t s FAF A to o plete the erifi atio pro ess. The stude t s pare t has not yet used the IRS Data Retrieval Tool, but will use the tool to transfer 2014 IRS income information into the stude t s FAF A o e the pare t s IR ta retur has ee filed. See instructions above for information on how to use the IRS Data Retrieval Tool. The Financial Aid Office cannot complete verification until the parent has transferred IRS information into the stude t s FAFSA. The parent is unable or chooses not to use the IRS Data Retrieval Tool, and the parent will su it to the stude t s s hool a op of the pare t s 2014 IRS tax return transcript(s). To obtain an IRS Tax Return Transcript go to www.irs.gov, and u der the Tools headi g, li k o Get Tra s ript of Your Ta Re ords, or call 1-800-908-9946. If requesting online, you may be able to print a pdf of your Tax Return Transcript immediately. Make sure to hoose Ta Retur. The parent will need his or her Social Security Number, date of birth, and the address on file with the IRS (normally this will be the address used when the 2014 IRS tax return was filed). It takes two to three weeks for IRS income information to be available for electronic IRS tax return filers, and eight to eleven weeks for paper tax return filers. If the parents are married, and separate 2014 tax returns were filed, 2014 IRS tax return transcripts must be submitted for each parent. Check here if a 2014 IRS Tax Return Transcript(s) is attached to this worksheet. Copies of IRS Tax Returns cannot be used to complete verification requirements. Check here if 2014 IRS Tax Return Transcript(s) will be submitted to the Financial Aid Office later. Verification cannot be completed until the IRS Tax Return Transcript(s) has been submitted to the Financial Aid Office. 2. TAX RETURN NONFILERS Co plete this se tio if the stude t s pare t s ill ot file a d is not required to file a 2014 income tax return with the IRS. The parent(s) was not employed and had no income earned from work in 2014. The parent(s) was employed in 2014 a d has listed elo the a es of all the pare t s e plo ers and the amount earned from each employer in 2014. 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. If ore spa e is eeded, atta h a separate page ith the stude t s a e a d o ial e urit Nu er or Brenau student ID number at the top. E plo er s Na e 2014 Amount Earned IRS W-2 Attached? uz s Auto Bod hop (example) $2,000.00 (example) Yes (example) Note: We may require you to provide documentation from the IRS that indicates a 2014 IRS income tax return was not filed with the IRS. 3

E. PARENT S OTHER INFORMATION TO BE VERIFIED 1. Complete this section to confirm whether or not so eo e i the stude t s pare t s household listed i e tio B re ei ed e efits fro the Supplemental Nutrition Assistance Program or SNAP* (formerly known as food stamps) any time during the 2013 or 2014 calendar years. *SNAP may be known by another name in some states. For assistance in determining the name used in a state, please call 1-800-433-3243. Yes, at least one of the persons listed in Section B of this worksheet received SNAP benefits in 2013 or 2014. If requested by the Brenau Financial Aid Office, I will provide documentation of the receipt of SNAP benefits during 2013 and/or 2014. No person listed in Section B of this worksheet received SNAP benefits in 2013 or 2014 2. Co plete this se tio if o e of the stude t s pare ts paid hild support i 4. O e or oth of the stude t s pare ts listed i e tio B of this orksheet paid child support in 2014. The parent has indicated 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 2014 for each child. If asked by the school, I will provide documentation of the payment of child support 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 or similar record of electronic payments having been made. If you need more spa e, atta h a separate page that i ludes the stude t s a e a d o ial Security Number or Brenau student ID number at the top. Name of Person Who Paid Child Support Name of Person to Whom Child Support was Paid Name of Child for Whom Support Was Paid Amount of Child Support Paid in 2014 Marty Jones Chris Smith (example) Terry Jones $6,000.00 F. VERIFICATION OF OTHER UNTAXED INCOME FOR 2014 Instructions: If a ite does ot appl, e ter N/A for Not Appli a le here a response is requested, or enter 0 in an area where an amount is requested. If the student was required to provide parental information on the FAFSA, answer each question below as it applies to the student and the stude t s pare t s hose i for atio is o the FAFSA. To determine the correct annual amount for each item: If you paid or received the same dollar amount every month in 2014, multiply that amount by the number of months in 2014 you paid or received it. If you did not pay or receive the same amount each month in 2014, add together the amounts you paid or received each month. If ore spa e is eeded, pro ide a separate page ith the stude t s a e a d ID u er 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 2014 Attach copies of all 2014 IRS W-2 forms issued to the student and to the parent(s) by employers. 4

tude t s o ial e urit Nu ber or Brenau ID 2. Child support received. List the actual amount of any child support received in 2014 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 3. 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 4. Veterans non-education benefits. List the total amount of veterans non-education benefits received in 2014. Include Disability, Death Pension, Dependency and Indemnity Compensation (DIC), and/or VA Educational Work-Study allowances. Do not include federal veterans educational benefits such as: Montgomery GI Bill, Dependents Education Assistance Program, VEAP Benefits, Post-9/11 GI Bill. Type of Veterans Non-education Benefit Amount of Benefit 5. Other untaxed income. List the amount of other untaxed income not reported and not excluded elsewhere on this form. Include u ta ed i o e su h as orkers o pe satio, disa ilit, Bla k Lu g Be efits, u ta ed portio s of health sa i gs a ou ts 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 student aid, Earned Income Credit, Additional Child Tax Credit, Temporary Assistance to Needy Families (TANF), untaxed Social Security benefits, Supplemental Security Income (SSI), Workforce Investment Act (WIA) educational benefits, combat pay, benefits from flexible spending arrangements (e.g., cafeteria plans), foreign income exclusion, or credit for federal tax on special fuels. Type of Other Untaxed Income Amount of Other Untaxed Income 6. Money recei ed or paid o the stude t s behalf. List a o e re ei ed or paid o the stude t s ehalf e.g., pa e t of stude t s bills) and not reported elsewhere on this form. Enter the total amount of cash support the student received in 2014. Include support from a parent whose information was not reported o the stude t s 5 2016 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 u less the perso is the stude t s pare t hose i for atio is reported o the stude t s 2015 2016 FAFSA. A ou ts paid o the stude t s ehalf also i lude a distri utio s to the stude t fro a 5 9 pla owned by so eo e other tha the stude t or the stude t s pare ts, such as grandparents, aunts, and uncles of the student. Purpose: e.g., Cash, Rent, Books Amount Source 5

7. Additional information: o that e a full u dersta d the stude t s fa il 's fi a ial situatio, please pro ide elo i for atio a out a other resour es, e efits, a d other a ou ts re ei ed the stude t a d a e ers of the stude t 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 include such things as federal veterans education benefits, military housing, SNAP, TANF, etc. If more space is needed, provide a separate page with the stude t s a e a d ID u er at the top. Type of Financial Support Amount of Financial Support Comments: G. CERTIFICATION AND SIGNATURES Each person signing this form certifies that all the information reported on it is complete and correct. The student and at least one parent whose information is reported on the FAFSA must sign and date. Student s Sig ature Date Parent s Sig ature Date WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both. H. VERIFICATION DEADLINES In order to receive most types of federal student aid, including Federal Direct Loans, all verification documents must be received by the Fi a ial Aid Offi e o later tha da s prior to the stude t s last date of atte da e i his/her fi al e roll e t ter of the 2015-16 academic year. Ho e er, to re ei e a Pell Gra t o l, assu i g a alid FAF A as re ei ed prior to the stude t s last date of atte da e, all erifi atio do u e ts ust e re ei ed o later tha 9 da s after the stude t s last date of atte da e for 5-16, or September 1, 2016, whichever date is earlier. Do not mail this worksheet to the Department of Education; submit this worksheet to: Brenau University Financial Aid Office 500 Washington St SE Gainesville, GA 30501 Fax: 770.538.4306 Email: financialaid@brenau.edu You should make a copy of this worksheet for your records. 6