Verification Worksheet
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5421 N Woodland Blvd., Unit 8379, DeLand, FL 32723
Phone: (386) 822-7120 Fax: (386) 822-7126 Email: finaid@stetson.edu
VERIFICATION WORKSHEET
Your file has been selected for verification of the data provided on your Free Application for Federal Student Aid (FAFSA). We cannot evaluate
your eligibility for financial aid until you submit all required verification documents. Delays in completion and submittal of this form may result in
limited funding for 2016-2017. ***If needed, we reserve the right to request additional documents that are not specified on this form.***
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Student SU ID
Student Full Name
Last Name
First Name
M.I.
E-mail
Phone Number
SECTION A:
Living Arrangements during the 2016-2017 academic year (check one)
On Campus
Living with Parent/Relatives
Living Off Campus
SECTION B:
Household
List people in your parent(s)' household, please include:
Yourself (If independent, please disregard all parental information requested on this worksheet).
Your parent(s)/step-parent you live with (do not include a parent not living in household due to
or divorce)
separation
Your parent's children if they receive more than half of their support from your parents from July 1, 2016 through June 30, 2017 or they
.
assistance
would be required to provide parental information when applying for federal financial
Other people, if they now live with your parents, they receive more than half of their support from your parents and continue to do so from
July 1, 2016 through June 30, 2017. If you need more space, attach a separate page.
Date of Birth
Please CHECK if
Full Name of family member
Relationship to
Name of Accredited
claimed on 2015
ex. 08/26/1990
Begin with your self
student
College Attending
tax return
Do not leave blank
Stetson
SELF
University
SECTION C: Information SNAP Benefits
The parents (and student if Independent) certify that _______________________________________, a member of the family
household, received benefits from the Supplemental Nutrition Assistance Program (SNAP) sometime during 2014 or 2015.
SNAP may be known by another name in some states. For assistance in determining the name used in a state, please call 1-
800-4FED-AID (1-800-433-3243).
SECTION D:
Child Support Paid
If you or your parent made child support payments during the 2015 calendar year additional information is required regarding
these payments. If this does not apply to you or your parents, please list "N/A" or "0".
*Child support cannot be listed as paid for children that are listed in the household.
Name of Person to Whom Child Support
Name and age of Child for Whom
Annual Amount of Support
Name of Person Who Paid Child Support
Support was Paid
was Paid
Paid in 2015
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DVERIF_1516
RV 3/8/16
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