Financial Aid Verification Worksheet Template Page 2


Student Name:__________________________________________
Student ID Number:_______________________
Tax and Income Information
• Submit copies of all W-2 forms received for working at any time in 2015.
• Submit an official IRS Tax Return Transcript if you filed a 2015 U.S. Tax Return and:
• You did not use the IRS Data Retrieval Tool when you filed your FAFSA, or
• You used the IRS Data Retrieval Tool and then made changes to the data on your FAFSA.
• If you filed a Foreign Tax Return:
• Submit a signed and dated copy of the form to our office. The form must be translated into English, OR
• Submit a statement of income, if you earned income in a country that does not require you to file tax returns.
To request an IRS Tax Return Transcript:
• To request a transcript online, go to Request the 2015 Tax Return Transcript.
• To order by phone, call 800-908-9946 and follow the prompts.
Review each statement and choose the one that best fits your situation
Answer for both student and spouse or parent (if dependent)
a. I did not work or I have no earned income from working in 2015. No required documentation.
b. I worked in 2015 but I was not required to file a 2015 Federal Income Tax return with the IRS.
Attach copies of all federal W-2 forms and/or 1099 forms.
Non-filer’s Name
2015 Earnings
W-2 Form(s) Included
c. I used the IRS Data Retrieval Tool to transfer my 2015 IRS Tax information to the FAFSA.
Attach copies of all federal W-2 forms and federal schedules (such as C, F, K-1, etc.)
d. I did NOT use the IRS Data Retrieval Tool to transfer my 2015 IRS Tax information to the FAFSA.
Attach 2015 IRS Tax Return Transcript and copies of all federal W-2 forms
e. I made changes to the transferred data after using the IRS Data Retrieval on my FAFSA.
Attach 2015 IRS Tax Return Transcript and copies of all federal W-2 forms
f. I have a unique Tax Situation (Contact the Financial Aid Office):
Filed an amended 2015 Tax Return
Filed a 2015 Federal Tax Extension
Was the victim of Identity Fraud
Other Information to be Verified:
Please list dollar amounts or 0 for the following items:
a. Taxable earnings from Federal Work-Study or other need-based work program.
b. Child support received in 2015 for all children, not including foster or adoption payments.
c. Housing, food and other living allowances for military, clergy, or paid by others, including cash
payments and cash value of benefits, that were received in 2015.
d. Cash received or money paid on your behalf from someone other than the supporting parent(s)
in 2015. Source:_______________________________________________________________________
e. Veteran’s non-educational benefits and/or VA Education Work-Study allowance.
f. Other untaxed income not reported, such as workers’ compensation, disability, untaxed pen-
sions, etc. (do not include Social Security Benefits). Provide documentation.
g. 2015 Low Income Certification: If the parent(s) of a dependent student or independent student
(and spouses, if applicable) had earned income less than $6,000 in 2015, please submit a
detailed explanation of 2015 household income and expenses. Include how expenses such as
housing, food, utilities, etc. were paid throughout the year. (Attach a separate sheet)
Signatures: Each person signing this form certifies that all information reported on it is complete and correct. If you purposely
give false or misleading information, you may be fined, sentenced to jail, or both.
Student’s Signature
Parent’s Signature (must be from the parent who signed the FAFSA)


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