Verification Of Child Support Paid By Parent printable pdf download

Verification Of Child Support Paid By Parent

Financial Aid

Form 5A

141 College Drive, Albemarle, NC 28001

Tel: (704) 991-0302 Fax: (704) 991-0160

financialaid@stanly.edu

2015-2016

VERIFICATION OF CHILD SUPPORT PAID BY PARENT

Student Name: __________________________________

ID Number: __________________

Your 2015-2016 FAFSA indicates that your parent may have paid child support during 2014.

This form must be completed and returned to the SCC Financial Aid Office.

Option 1. Did Not Pay child support in 2014

Check here if your parent did not pay child support during 2014.

Option 2. Did Pay child support in 2014

Check here if your parent did pay child support during 2014:

If so, please complete the chart below and attach official documentation of the support paid.

Name of Parent Who Paid

Name of Person to Whom

Name of Child for Whom

Amount for Child Support

Child Support

Child Support was Paid

Support was Paid

Paid in 2014

Ex.

Marty Jones

Chris Smith

Terry Jones

6,000.00

*Official documentation can include but is not limited to a statement from the NC Child Support Enforcement Agency, a

statement from the person to whom the support was paid or, a copy of the child support order.

Acknowledgement: I certify that the above information is true and accurate to the best of my knowledge.

_______________________________ _________ _______________________________ _________

Parent Signature

Date

Student Signature

Date

WARNING: If you purposely give false

or misleading information, you may be

Revised January 2015

fined, sentenced to jail, or both.

Verification Of Child Support Paid By Parent