V1 Verification Form

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Arkansas State University
2013-2014 Financial Aid & Scholarships
V1 Verification Form
Your 2013–2014 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.
Student Name (Last Name, First Name, Middle Name/Initial)
ASU ID Number
Phone Number (
)
Information About Family Members
Please indicate marital status as of today:
Student Marital Status
Date of Occurrence
Parent Marital Status
Date of Occurrence
Married/Remarried
Married/Remarried
Divorced
Divorced
Separated
Separated
Widowed
Widowed
Single
Single
List people in your household, include:
Yourself, spouse (if married), and children,
OR
Yourself and your parent(s) (including step-parent) if you are under age 24 and will not provide more than half of your childrens’
support, AND
Your parents’ other children, if your parent(s) will provide more than half of the other childrens’ support from July 1, 2013
through June 30, 2014, AND
Other dependent individuals that live in your household and receive half of their support from your household, and will continue
to be supported by your household from July 1, 2013 through June 30, 2014. (Additional documentation may be required)
Indicate the name of the college for any family member (not including graduate students) who will be attending at least half-time (six credit hours)
and is working toward a degree or certificate at a school eligible to participate in the Federal Student Aid programs. Attach additional page if needed.
Enrolled at
Full Name
Age
Birthdate
Relationship to Student
College
Least Half-Time
Janet Jones(example)
20
03/01/1991 Sister
Central University
Yes
Self
Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps)
No one living in the household received SNAP benefits in 2011 or 2012.
One or more persons living in the household received SNAP benefits in 2011 or 2012. You must provide documentation from
the Department of Human Services to verify receipt of SNAP Benefits during 2011 or 2012.
(continued)

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