Fillable 2009-2010 Verification Worksheet Template printable pdf download

Dependent

2009-2010 Verification Worksheet

Federal Student Aid Programs

FORM APPROVED

OMB NO. 1845-0041

U.S. Department

of Education

What you should do

Your application was selected for review in a process called

“Verification.” In this process, your school will be comparing

1. Collect your and your parent(s)’ financial documents (signed

information from your application with signed copies of your

Federal income tax forms, W-2 forms, etc.).

and your parent(s)’ 2008 Federal tax forms, or with W-2 forms or

2. Talk to your financial aid administrator if you have questions

other financial documents. The law says we have the right to ask

about completing this worksheet.

you for this information before awarding Federal aid. If there are

3. Complete and sign the worksheet—you and at least one

differences between your application information and your finan-

parent.

cial documents, you or your school may need to make corrections

4. Submit the completed worksheet, tax forms, and any other

electronically or by using your Student Aid Report (SAR).

documents your school requests to your financial aid

administrator.

Complete this verification form and submit it to your financial aid

5. Your financial aid administrator will compare information on

administrator as soon as possible, so that your financial aid won’t

this worksheet and any supporting documents with the

be delayed. Your financial aid administrator will help you.

information you submitted on your application. You or your

school may need to make corrections electronically or by

using your SAR.

A. Student Information

Social Security Number

Last name

First name

M.I.

Address (include apt. no.)

Date of birth

Phone number (include area code)

City

State

ZIP Code

B. Family Information

List the people in your parent(s)’ household, including:

• yourself and your parent(s) (including stepparent) even if you don’t live with your parents, and

• your parents’ other children, even if they don’t live with your parent(s), if (a) your parents will provide more than half of their

support from July 1, 2009 through June 30, 2010, or (b) the children would be required to provide parental information when

applying for Federal Student Aid, and

• 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 of their support from July 1, 2009 through June 30, 2010.

Write the names of all household members in the space(s) below. Also write in the name of the college for any household member,

excluding your parent(s), who will be attending at least half time between July 1, 2009 and June 30, 2010, and will be enrolled in a

degree, diploma, or certificate program. If you need more space, attach a separate page.

Full Name

Age

Relationship

College

Sister

Central University

Missy Jones

(example)

Self

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection

is 1845-0041. The time required to complete this information collection is estimated to average twelve minutes, including the time to review instructions, search existing data resources, gather the data needed, and complete and re-

view the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: US Department of Education, Washington, DC 20202-5345.

2009-2010 Verification Worksheet Template

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