Form Dep - V5 - Dependent Verification Worksheet Page 2
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3Part 3. Family Information:
List the persons in your parent’s household in the chart below. Include the following:
1.
Yourself, even if you don’t live with your parents (i.e. - living in an apartment, with friends, etc.)
2.
Your parent(s)in the household, including your stepparent
3.
Your parents’ other children if:
a)
Your parents will provide more than half of the other children’s’ support from July 1, 2016 to June 30, 2017
4.
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 their support from July 1, 2016 to June 30, 2017.
Also, identify the name of the college for any family member (except your parents) who will be attending college between July 1, 2016
and June 30, 2017 and will be enrolled at least half-time in a degree or certificate program. If you need more space add a separate page.
First and Last Name*
Age Relationship
Name of College in 2016-2017** Enrolled at least ½ time
Example:
Martha Jones
19
Sister
Fort Lewis
Yes
1. (Student):
SELF
2.
3.
4.
5.
6.
*Proof of financial support may be requested. **Proof of enrollment in 2016-2017 may be requested.
Part 4. Additional Information
A. SNAP (Food Stamps) received in 2014 and/or 2015
1.
Did anyone listed in your household in Part 3 above receive SNAP or Food Stamps in 2014 or 2015?
YES _________
If “yes” you MUST attach a copy of the benefit letter or other proof of receiving this benefit.
NO _________
B. Child Support Paid in 2015
1.
Did one of your parents listed in Part 3 PAY child support in 2015?
YES _______
if “yes” answer questions 2 through 5 below.
NO _______
2. Write the TOTAL amount actually paid in all of 2015: $ _______________________
3. Name of person who paid child support in 2015?
_________________________________________
4. Name the person to whom child support was paid: _________________________________________
5. List the children for whom the child support is intended: _____________________________________
_____________________________________
_____________________________________
*If the figure differs from what was reported on the FAFSA further documentation (cancelled checks, legal documents, etc.) may be requested.
Part 5. Student’s Proof of High School Completion
The school must have documentation the student completed high school or its accepted equivalent.
1.
Did you previously submit documentation of high school, home school, or GED completion to SJC:
YES _____ If ‘yes’ initial the statement below.
Student initials: _______
I previously submitted a copy of my official high school transcript, GED or homeschool credential to
SJC. If, upon review, this document is not sufficient I will submit additional required documentation.
NO _____ If ‘no’ go to the list below and SELECT ONLY ONE of the following choices, CHECK the line, and ATTACH A COPY of the form.
_____ Final official high school transcript showing graduation date
_____ GED certification
_____ An acceptable homeschool completion credential meeting New Mexico and SJC requirements
If you cannot provide one of these documents please contact the financial aid office.
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