2021-2022 Verification Worksheet V1Your 2021-2022 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 must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the financial aid administrator at your school. Your school may ask for additional information. If you have questions about verification, contact your financial aid administrator as soon as possible so that your financial aid will not be delayed.Student Information* Name Student ID Student Social Security Number Email Address Contact and Address Cell Phone Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Dependency Status & Household Information Dependent Student Independent StudentList below the people in your parent’s household. Please Include:Yourself and your parent(s) (including stepparent) even if you don’t live with your parents.Your parents’ other children, if your parents will provide more than half of their support from July 1, 2021 through June 30, 2022, or the children would be required to provide parental information if they were completing a FAFSA for 2021-2022. 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 parents and your parents provide more than half of their support and will continue to provide more than half of their support through June 30, 2022.Include the name of the college for any household member EXCLUDING YOUR PARENT(s) , who will be attending at least half time between July 1, 2021 and June 30, 2022, enrolled in a degree or certificate program. Attach separate sheet for more spacePerson 1 Dr.MissMr.Mrs.Ms.Prof.Rev. Full Name Age Relationship College or University (only) Will Be Enrolled at least Half time Person 2 Dr.MissMr.Mrs.Ms.Prof.Rev. Full Name Age Relationship College or University (only) Will Be Enrolled at least Half time Person 2 Dr.MissMr.Mrs.Ms.Prof.Rev. Full Name Age Relationship College or University (only) Will Be Enrolled at least Half time Person 3 Dr.MissMr.Mrs.Ms.Prof.Rev. Full Name Age Relationship College or University (only) Will Be Enrolled at least Half time Person 4 Dr.MissMr.Mrs.Ms.Prof.Rev. Full Name Age Relationship College or University (only) Will Be Enrolled at least Half time Person 5 Dr.MissMr.Mrs.Ms.Prof.Rev. Full Name Age Relationship College or University (only) Will Be Enrolled at least Half time The next section contains income information for students and Parents. A copy of tax filers 2019 IRS Tax Return and W-2 Form must be attached to this document. Student Income Information Student Name SSN Tax Filing Students Yes, I have used the IRS Data Retrieval tool to retrieve and transfer my 2019 IRS income information on the FAFSA. I, have not used the IRS Data Retrieval Tool, but will use the tool to transfer my 2019 IRS income information to the FAFSA once I have filed. _I, am unable or choose not to use the IRS Retrieval tool on the FAFSA. I will submit my 2019 IRS tax return transcript.Non Tax Filing Students with LOW or No Income (COMPLETE THIS SECTION IF YOU DID NOT FILE TAXES IN 2019) No…I, the student, did not work and are not required to file a tax return for 2019. _No…I, the student, did not work but had supporting income {Please complete Table A}2019 Source of IncomeChild Support RecievedTotal Amount 2019 Source of IncomeWorkers’ CompensationTotal Amount 2019 Source of IncomeSocial Security or Disability BenefitsTotal Amount 2019 Source of IncomeWelfare benefits (TANF)Total Amount Untaxed PensionsChild Support RecievedTotal Amount 2019 Source of IncomeMonetary support (Money received or paid on your behalf for necessities such as food, bills, housing and living allowance, etc.)Total Amount Sources of Income Total Amount Yes…I, or my spouse (if married) were employed but did NOT file.MUST attach a copy of your W-2 Form(s). {Complete Table B}Max. file size: 256 MB.W-2 InformationEmployer's Name2019 Amount EarnedW-2 Attache W-2 InformationEmployer's Name2019 Amount EarnedW-2 Attache W-2 InformationEmployer's Name2019 Amount EarnedW-2 Attache (INDEPENDENT STUDENTS ONLY….STOP HERE!!!!!!!!!)* I/we certify that all information reported is complete and correct. I/we understand that no federal aid can be awarded or disbursed until the verification process is complete.Father's Infromation SSN DOB Mother's Informatoin SSN DOB ONLY USE BOTH PARENTS INFORMATION IF PARENTS ARE MARRIED I/we, the student’s Parent(s), did work and have completed my Federal Income Tax for 2019. Attached is a copy of IRS Tax Return Transcript and W-2 Form(s). I/we, the student’s parent(s) did work and have completed my Federal Income Tax for 2019. I/we will be submitting a copy of the IRS Tax Return Transcript and W-2 Form(s) at a later date. I/we, the student’s parent(s) did work but HAVE NOT completed my/our Federal Income Tax at this time. I/we will be submitting the IRS Tax Return Transcript once I/we have filed.NON TAX FILING PARENTS ONLY No…I, the Student’s Parent was not employed and had ZERO INCOME for 2019. No…I, the Student’s Parent DID NOT work but had supporting income for 2019. {Must Complete Table C Below}Table C {Please Include a Copy of Supporting Documents}2019 Source of IncomeChild Support ReceivedTotal Amount 2019 Source of IncomeSocial Security or Disability BenefitsTotal Amount 2019 Source of IncomeWelfare benefits (TANF)Total Amount 2019 Source of IncomeUntaxed PensionsTotal Amount 2019 Source of IncomeMonetary support (Money received or paid on your behalf for necessities such as food, bills, housing and living allowance, etc.)Total Amount 2019 Source of IncomeWorkers’ CompensationTotal Amount 2019 Total Amount of IncomeNon Tax Filing Parents Yes…I, or my spouse (if married) were employed but did not file.Attached is a copy of my W-2 Form(s). {Must Complete Table E Below}Max. file size: 256 MB.Table EEmployers Name2019 Amount EarnedW-2 Atached Table EEmployers Name2019 Amount EarnedW-2 Atached Table EEmployers Name2019 Amount EarnedW-2 Atached Consent is on behalf of student and parent* I/we certify that all information reported is complete and correct. I/we understand that no federal aid can be awarded or disbursed until the verification process is complete.