Verification Worksheet
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4FINANCIAL AID OFFICE
State University of New York at Fredonia
209 Maytum Hall, Fredonia, NY 14063
Phone 716-673-3253 • Fax 716-673-3785
financial.aid@fredonia.edu •
u 2016-17 VERIFICATION WORKSHEET
DEPENDENT
IMPORTANT NOTE
Your application was selected for review in a process called “Verification.” In this process, your school will be comparing information
from your FAFSA with information on this worksheet and other financial documents. The law says we have the right to ask you for
this information before awarding Federal aid. If there are differences between your FAFSA information and your financial documents,
you or the Office of Financial Aid may need to make corrections electronically.
Complete this verification form (DO NOT LEAVE ANY LINES BLANK) and submit to the Office of Financial Aid as
soon as possible, so that your financial aid won’t be delayed. This process can take up to six weeks. Your financial aid
administrator will help you if you have any questions.
A. STUDENT INFORMATION
_______________________________________
_______________________________________
Last Name
First Name
M.I.
Student’s Fredonia ID Number
_______________________________________
_______________________________________
Address (include apt. no.)
Date of Birth
_______________________________________
_______________________________________
City
State
Zip Code
Phone Number (include area code)
B. FAMILY INFORMATION
List below the people that your parents will support between July 1, 2016 and June 30, 2017. Include:
• yourself, even if you don’t live with your parents
• your parent(s) – (including stepparent)
• your parent(s)’ other children (even if they don’t live with your parent(s), and (a) your parent(s) provide more than half of their
support or (b) if they would be required to give parental information when applying for Federal student aid.)
Include other people as part of your family only if:
• they now live with your parent(s) and received more than half of their support from your parents(s) AND
• they will continue to get more than half of their support from July 1, 2016 through June 30, 2017.
Also write in the name of the college for any household member, excuding your parent(s), who will be attending college at least half-
time between July 1, 2016 and June 30, 2017, 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 (at least half time)
Self
Fredonia
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