Office of Financial Aid at Rider University 2083 Lawrenceville Road Lawrenceville, New Jersey 08648 (609) 896-5360 Fax: 609-219-4487 Dependent Verification Document 2018-2019 We are requesting you verify the information reported on your financial aid application. Please follow the instructions carefully and return all requested documentation to the Office of Financial Aid as soon as possible. If you have already provided this office with any of the requested documents, please note it next to the appropriate place on this form. We will not be able to provide financial aid if you fail to complete the verification process. If you have any questions concerning this process, please contact the Office of Financial Aid at (609) 896-5360. Please complete each part in its entirety and print clearly. PART 1 - STUDENT INFORMATION Name (last name, first name, middle initial) Social Security No. Address Home Phone (123) 456-7890 City State Zip Code of Birth PART 2 - STUDENT FEDERAL TAX INFORMATION Did or will you file a federal income tax return for 2016? YES NO (IRS form 1040, 1040A, 1040EZ or appropriate form from country of residence) If YES, attach your complete 2016 IRS tax return transcript (all pages), along with a copy of your W-2 s. To obtain an IRS tax return transcript go to www.irs.gov and click on the Get Transcript for My Tax Records link, or call 1-800-829-1040. Make sure you order the IRS return transcript and NOT the IRS account transcript. More detailed directions on how to obtain your tax return transcript are enclosed. If NO, list below all your sources and amounts of income (if any) received in 2016 and sign the following statement: EMPLOYER/SOURCE OF INCOME AMOUNT RECEIVED Note: For each employer, $ please provide a W-2. $ I certify that I DID NOT, I WILL NOT, and I AM NOT REQUIRED TO file a federal tax return for 2016. _ Student s signature PART 3 - PARENT(S) FEDERAL TAX INFORMATION Did or will the student s parent(s) file a federal income tax return for 2016? (IRS form 1040, 1040A, 1040EZ or appropriate form(s) from country of residence) YES NO If YES, attach your parent(s) complete 2016 IRS tax return transcript (all pages), along with your parent(s) W-2 s. To obtain an IRS tax return transcript go to www.irs.gov and click on the Get Transcript for My Tax Records link, or call 1-800-829-1040. Make sure you order the IRS return transcript and NOT the IRS account transcript. More detailed directions on how to obtain your tax return transcript are enclosed.
If NO, list below all your sources and amounts of income (if any) received in 2016 and sign the following statement: EMPLOYER/SOURCE OF INCOME AMOUNT RECEIVED Note: For each employer, $ please provide a W-2. $ I certify that I DID NOT, I WILL NOT, and I AM NOT REQUIRED TO file a federal tax return for 2016. _ Parent s signature _ Parent s signature PART 4 - INFORMATION ABOUT FAMILY MEMBERS For parental and household questions on this form, please note the following guidelines: The number of household members for dependent students must include both of a dependent s students legal (biological or adoptive) parents if the parents live together, regardless of the marital status or gender of the parents. Grandparents, foster parents and legal guardians are not considered parents on this form unless they have legally adopted you. If your parent is widowed or single, answer the questions about that parent. If your widowed parent is remarried, answer the questions about that parent and your stepparent. If your parents are divorced or separated, answer the questions about the parent you lived with more during the past 12 months. If you did not live with one parent more than the other, give answers about the parent who provided more financial support during the past 12 months. If this parent is remarried, answer the questions about that parent and your stepparent. What is your parents marital status as of today? Married/Remarried Divorced Separated Widowed Single Please indicate the month and year of your parent(s) last marital change: In the space provided below, list all the people in your parents household. Be sure to include: yourself and your parent(s) (including stepparent), even if you don t live with your parents, and your parents other children, even if they don t live with your parent(s), if (a) your parents will provide more than half of their support between July 1, 2018 and June 30, 2019, or (b) the children would be required to provide parental information when applying for Federal Student Aid, and other people only if they live with your parents, your parents provide more than half of their support and your parents will continue to provide more than half of their support between July 1, 2018 and June 30, 2019, and the names of the college for any household member, excluding your parent(s), who will be attending college at least half time between July 1, 2018 and June 30, 2019, and will be enrolled in a degree, diploma, or certificate program. If you need more space, attach a separate page. College enrollment is subject to verification. Name of Family Member Jane Doe (Example) Relationship To Student of Birth College in 2018-2019 Will attend at least half time (6 credits) Expected Year of Graduation Sister 2/11/95 Central Univ. Yes 2019 Self Rider Univ.
PART 5 - UNTAXED INCOME FOR 2016 Did you and/or your parent(s) receive any untaxed income and benefits for 2016? YES NO If YES, complete the following and provide the appropriate documentation. All amounts and documentation must be for the entire year of 2016. Do not provide a monthly statement of current benefits. Student Parent $ $ Payments to tax-deferred pensions, retirement and savings plans (paid directly or withheld from earnings). $ $ Child support received (total amount). For how many children? $ $ Housing, food, and other living allowances paid to members of the military, clergy, and others (including cash payments and cash value of benefits) $ $ Veterans non-education benefits (such as Disability, Death Pension, Dependency and Indemnity Compensation, etc.) $ $ Any other untaxed income and benefits, such as worker s, compensation, disability, etc. Do not include welfare payments, untaxed Social Security Benefits, and Supplemental Security Income. $ $ Other (please specify): PART 6 - STUDENT FEDERAL WORK-STUDY INCOME FOR 2016 Did you participate in the Federal Work-Study program during 2016? YES NO If YES, how much income was earned through the Federal Work-Study program in 2016: $ PART 7 - CHILD SUPPORT PAYMENTS Did the parent(s) listed on this document pay child support for non-custodial children in 2016? YES NO (List support for children who did not reside with your parent(s) but to whom your parent(s) were required to provide monies per a divorce or separation agreement. These children cannot be listed in PART 4). If YES, complete the following chart. 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 2016 Note: We may require additional documentation PART 8 CASH, SAVINGS & CHECKING ACCOUNTS Complete the following by indicating the total current balance of cash, savings and checking accounts as of today. If zero, please write 0 (do not skip). For this section, do not include any of the investments listed in Part 9. Parents balance in cash, savings and checking accounts: Student s balance in cash, savings and checking accounts: $ $
PART 9 NET WORTH OF INVESTMENTS In the space below, indicate the net worth of investments as of today. If none, please write zero (do not skip). Investments include real estate (not primary residence), trust funds, UGMA and UTMA accounts, money market funds, mutual funds, certificates of deposit, stocks, stock options, bonds, other securities, Coverdell savings accounts, 529 college savings and prepaid tuition plans, installment and land sale contracts including mortgages held, commodities, etc. Do not include the value of your primary residence (home) except for any rental portion that is not owner occupied. Do not include the value of life insurance or retirement plans (pension funds, annuities, noneducation IRAs, Keogh plans, etc.). Investment value means the current balance or market value of these investments as of today. Investment debt means only those debts directly related to the investments. If there were significant changes in investment values over what was reported on the FAFSA, please provide an explanation and supporting documents. Attach additional page(s) if necessary. Parent Value/Debt Student Value/Debt Investment 1: Investment 1: Investment 2: Investment 2: PART 10 CURRENT BUSINESSES Do you or your parents own a business with more than 100 full-time (or full-time equivalent) employees? YES NO If YES, provide information below for each business, and attach the respective 2016 business tax return and balance sheet (Form 1065, 1120, or 1120S). Business value includes the value of the land, buildings, machinery, equipment and inventory. Business debt means only those debts for which the business was used as collateral. Attach additional page(s) if necessary. If NO, you do not have to provide business information. Skip to Part 11. Parent Value/Debt Student Value/Debt Business 1: Business 1: Business 2: Business 2: PART 11 CERTIFICATION Please check this form for accuracy and completeness. This form will be returned if incomplete and/or if documents are missing. WARNING: IF YOU PURPOSELY GIVE FALSE OR MISLEADING INFORMATION ON THIS FORM, YOU MAY BE FINED, SENTENCED TO JAIL, OR BOTH. By signing this form, we certify that all the information reported on it is complete and correct. Student s signature Parent s signature Did you remember to... Complete all items? Include a complete IRS tax return transcript(s) (all pages) and W-2s? Provide all other required documentation? Sign the document and have at least one parent sign as well? 2018-19 Dep Verif Doc
Please note: Federal verification requirements have changed. Please read the form carefully, follow the instructions, and do not leave any items blank. Be sure to provide the following: Your complete 2016 IRS tax return transcript. (See attached directions) A copy of your 2016 W-2 Form(s). and Your parent(s) complete 2016 IRS tax return transcript. (See attached directions) A copy of your parent(s) 2016 W-2 Form(s). If your parent(s) did not file a 2016 Federal Tax Return, your parent(s) will need to request the IRS to provide confirmation. This requires the completion of IRS Form 4506-T. This form can be printed from your myrider portal or by visiting https://www.irs.gov/pub/irs-pdf/f4506t.pdf. Make sure to check box 7 on the form. You will mail the completed IRS Form 4506-T to the IRS and they will provide you with a letter response, called a Verification of Nonfiling, a copy of which you will need to provide to the financial aid office. (Note: This letter just confirms that the IRS does not have a tax return on record. This letter does not mean that you were not required to file a return.) To ensure compliance, we will not disburse any funds until the verification process has been completed. Failure to submit all requested information will result in cancellation of your financial aid. If you have any questions about this process, please contact our office. Sincerely, Office of Financial Aid
IRS Tax Return Transcript Request Directions The verification process requires you to submit a copy of your and your parent(s) 2016 federal tax return transcripts. Below are ways to receive a copy of your tax return transcript. Option 1: Get Transcript Online (Suggested) Step 1: Go to www.irs.gov Step 2: Select Get My Tax Record Step 3: Select Get Transcript Online for an instant PDF version Step 4: If you have already created an online account with the IRS simply sign in. If you have never created an account click create an account and follow the on screen directions given. Step 5: Once you successfully create an account 1. Click the bubble to indicate you need the transcript for Higher Education/Student Aid. 2. Return transcript should be highlighted in green as the suggested form to download 3. Select 2016 Your Tax return transcript should open either in a new tab or window depending on your browser. Option 2: Get Transcript by Mail Step 1: Go to www.irs.gov Step 2: Select Get My Tax Record Step 3: Select Get Transcript by Mail for a mailed copy delivered to your home address Step 4: Follow directions on screen Enter Social Security Number, of Birth, Street Address, and Zip Code. Click Continue Step 5: Follow directions on screen 1: Under Type of Transcript, select Return Transcript 2: Under for Tax Year, select 2016 3: Click Continue A confirmation screen will appear. Your transcript will be mailed to you within 5 to 10 business days. Remember that you are required to provide Rider with a copy of your 2016 W-2 form(s) as well.