V5A 2019–2020 Verification Worksheet Independent Student (For student signing before a school official)

Your 2019–2020 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 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 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.

Independent Student’s Information

Number of Household Members and Number in College (Independent Student)

Number of Household Members: List below the people in the student’s household. Include:

  • The student.
  • The student’s spouse, if the student is married.
  • The student’s or spouse’s children if the student or spouse will provide more than half of the children’s support from July 1, 2019, through June 30, 2020, even if the children do not live with the student.
  • Other people if they now live with the student and the student or spouse provides more than half of the other person’s support and will continue to provide more than half of their support through June 30, 2020.
  • Number in College: Please include in the space below information about any household member who is or will be enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary educational institution any time between July 1, 2019, and June 30, 2020, include the name of the college. If more space is needed, provide a separate page with the student’s name and ID number at the top.

Will be Enrolled at Least Half Time
Will be Enrolled at Least Half Time
Will be Enrolled at Least Half Time
Will be Enrolled at Least Half Time
Will be Enrolled at Least Half Time
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.

Verification of 2017 Income Information for Student Tax Filers

Important Note: The instructions below apply to the student and spouse, if the student is married. Notify the financial aid office if the student or spouse filed separate IRS income tax returns for 2017 or had a change in
marital status after December 31, 2017.

Instructions: Complete this section if the student and spouse filed or will file a 2017 IRS income tax return(s). The best way to verify income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the Web at FAFSA.gov. In most cases, no further documentation is needed to verify 2017 income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed.

Check the box that applies:

The student has used the IRS DRT in FAFSA on the Web to transfer 2017 IRS income tax return information into the student’s FAFSA.
The student has not yet used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2017 IRS Income tax return information into the student’s FAFSA.
The student is unable or chooses not to use the IRS DRT in FAFSA on the Web, and instead will provide the school with a 2017 IRS Tax Return Transcript(s).
A 2017 IRS Tax Return Transcript may be obtained through:

  • Get Transcript by MAIL – Go to www.irs.gov, click "Get Your Tax Record.” Click “Get Transcript by Mail.”
    Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
    The transcript is generally received within 10 business days from the IRS’s receipt of the online request.
  • Get Transcript ONLINE – Go to www.irs.gov, click "Get Your Tax Record." Click “Get Transcript Online.”
    Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.” To use the Get Transcript Online tool, the user must have (1) access to a valid email address, (2) a text-enabled mobile phone (pay-as-you-go plans cannot be used) in the user’s name, and (3) specific financial account numbers (such as a credit card number or an account number for a home mortgage or auto loan). The transcript displays online upon successful completion of the IRS’s two-step authentication.
  • Automated Telephone Request – 1-800-908-9946. Transcript is generally received within 10 business
    days from the IRS’s receipt of the telephone request.
  • Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T. The transcript is generally received
    within 10 business days from the IRS’s receipt of the paper request form.
  • If the student and spouse filed separate 2018 IRS income tax returns, the IRS DRT cannot be used and the 2018 IRS Tax Return Transcript(s) or a 2018 signed IRS Tax Return & applicable schedules must be provided for each.

Check here if a 2017 IRS Tax Return Transcript(s) is provided.
Check here if a 2017 IRS Tax Return Transcript(s) will be provided later.

Verification of 2017 Income Information for Individuals with Unusual Circumstances

Individuals Granted a Filing Extension by the IRS

    An individual who is required to file a 2017 IRS income tax return and has been granted a filing extension by the IRS beyond the automatic six-month extension for tax year 2017, must provide:

  • A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income Tax Return,’’ that
    was filed with the IRS for tax year 2017;

  • A copy of the IRS's approval of an extension beyond the automatic six-month extension for tax year 2017;

  • Verification of Non-filing Letter (confirmation that the tax return has not yet been filed) from the IRS or other relevant tax authority dated on or after October 1,2018;
  • A copy of IRS Form W–2 for each source of employment income received or an equivalent document for tax year 2017 and, if self-employed, a signed statement certifying the amount of the individual’s Adjusted Gross Income (AGI) and the U.S. income tax paid for tax year 2017.
  • Individuals Who Filed an Amended IRS Income Tax Return
    An individual who filed an amended IRS income tax return for tax year 2017 must provide a signed copy of the 2017 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was filed with the IRS or documentation from the IRS that include the change(s) made by the IRS, in addition to one of the following:

  • IRS DRT information on an ISIR record with all tax information from the original tax return; or
  • A 2017 IRS Tax Return Transcript (that will only include information from the original tax return and does not have to be signed), or any other IRS tax transcript(s) that includes all if the income and tax information required to be verified.
  • Individuals Who Were Victims of IRS Tax-Related Identity Theft

    An individual who was the victim of IRS tax-related identity theft must provide:

  • • A Tax Return Data Base View (TRDBV) transcript obtained from the IRS, or any other IRS tax transcript(s) that
    includes all of the income and tax information required to be verified; and

  • • A statement signed and dated by the tax filer indicating that he or she was a victim of IRS tax-related identity theft and that the IRS is aware of the tax-related identity theft.
  • Individuals Who Filed Non-IRS Income Tax Returns

  • A tax filer who filed an income tax return with Guam, the Commonwealth of the Northern Mariana Islands, the Commonwealth of Puerto Rico and the U.S. Virgin Islands may provide a signed copy of his or her 2017 income tax return that was filed with the relevant tax authority. However, if we question the accuracy of the information on the signed copy of the income tax return, the tax filer must provide us with a copy of the tax account information issued by the relevant tax authority before verification can be completed.
  • A tax filer who filed an income tax return with the tax authority for American Samoa must provide a copy of his or her 2017 tax account information.
  • A tax filer who filed an income tax return with the tax authorities not mentioned above, i.e., foreign tax authority, and who indicates that he or she is unable to obtain the tax account information free of charge, must provide documentation that the tax authority charges a fee to obtain that information, along with a signed copy of his or her 2017 income tax return that was filed with the relevant tax authority.

Verification of 2017 Income Information for Student Nontax Filers

The instructions and certifications below apply to the student and spouse, if the student is married. Complete this section if the student and spouse will not file and are not required to file a 2017 income tax return with the IRS.

Check the box that applies:
The student was not employed and had no income earned from work in 2017.
The student and/or spouse was employed in 2017 and have listed below the names of all employers, the amount earned from each employer in 2017, and whether an IRS W-2 form is provided. [Provide copies of all 2017 IRS W-2 forms issued to the student and spouse by the employers]. List every employer even if the employer did not issue an IRS W-2 form.
IRS W-2 or an Equivalent Document Provided?
IRS W-2 or an Equivalent Document Provided?
IRS W-2 or an Equivalent Document Provided?
IRS W-2 or an Equivalent Document Provided?
Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2018 that indicates a 2017 IRS income tax return was not filed with the IRS or other relevant tax authority.
Check here if IRS confirmation of nonfiling is provided.
Check here if IRS confirmation of nonfiling will be provided later.

Identity and Statement of Educational Purpose (To Be Signed at the Institution)

The student must appear in person at above educational institution to verify his or her identity by presenting an unexpired, valid government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. The institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received and reviewed and the name of the official at the institution authorized to receive and review the student’s ID.

In addition, the student must sign, in the presence of the institutional official, the Statement of Educational
Purpose provided below:


Statement of Educational Purpose

I certify that I am the individual signing this Statement of Educational Purpose and that the Federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending above postsecondary educational institution for 2019-2020.
Documentation Presented (Valid Photo ID)
Maximum upload size: 104.86MB

High School Completion Status

Provide one of the following documents that indicate the student’s high school completion status when the student
will begin college in 2020–2021:

  • A copy of the student’s high school diploma.
  • For students who completed secondary education in a foreign country, a copy of the “secondary school leaving certificate” or other similar document.
  • A copy of the student’s final official high school transcript that shows the date when the diploma was awarded.
  • A State certificate or transcript received by a student after the student passed a State-authorized examination
    that the State recognizes as the equivalent of a high school diploma (GED test, HiSET, TASC or other State-authorized examination).

  • An academic transcript that indicates the student successfully completed at least a two-year program that is acceptable for full credit toward a bachelor’s degree.
  • For a student who was homeschooled in a State where State law requires the student to obtain a secondary school completion credential for homeschooling (other than a high school diploma or its recognized equivalent),
    a copy of that credential.

  • For a student who was homeschooled in a State where State law does not require the student to obtain a secondary school completion credential for homeschooling (other than a high school diploma or its recognized equivalent), a transcript, or the equivalent, signed by the student's parent or guardian, that lists the secondary school courses the student completed and includes a statement that the student successfully completed a secondary school education in a homeschool setting.
  • A student who is unable to obtain the documentation listed above must contact the financial aid office.

Certification and Signature (Independent Student)

WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or both.
Certifications and Signatures

Each person signing below certifies that all of the
information reported is complete and correct.