Verification Form Susquehanna University
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3Susquehanna University
2016-2017 VERIFICATION FORM - DEPENDENT STUDENT
Student Name
Student SSN
Last
First
MI
Student Date of Birth
Student Telephone Number
(
)
Student E-Mail
Parent Telephone Number
(
)
Parent E-Mail
Complete and sign this verification form and return it to Student Financial Services as soon as possible so that your financial aid won’t
be delayed. If you have any questions, please contact Student Financial Services staff at (570) 372-4450.
The federal Department of Education has selected your FAFSA for review in a process called “Verification.” SU is
required to collect information in this format to confirm that you have entered correct information on your FAFSA. Your
financial aid application cannot be processed until all requested information is received. Failure to complete the
verification process by the last enrolled day of the award period will result in a loss of aid. This review must be
conducted under the financial aid program rules (34 CFR, Part 668).
Successful completion of the Verification process requires that families provide income tax information for both the
student AND the student’s parent(s) in one of two ways:
1) Obtain a paper copy of the 2015 IRS Income Tax Transcript:
Call the IRS at 1-800/908-9946, or go to , to order.
Provide to the Financial Aid Office by mail or fax.
*****OR*****
2)
Submit (or re-submit) the 2016-2017 FAFSA ( ) and select the IRS data retrieval option. This is
available for most tax filers 2 weeks after filing taxes on-line or 6 weeks after filing by US Mail.
Please note that the Verification process will not be complete until all required Tax Transcripts are received or the
FAFSA is (re)submitted using the data retrieval function on the FAFSA website ( ).
F
I
AMILY
NFORMATION
List the people in your parent’s household. Include the following:
your parents (including stepparent) and yourself, even if you don’t live with your parents, and
your parents’ other children, even if they don’t live with your parents, if: (a) your parents will provide more than half of
their support from July 1, 2016 through June 30, 2017, AND (b) the children are under age 24 and neither married nor
veteran of the armed services 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, 2016 through June 30, 2017.
Also write in the name of the college for any household member 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. Attach an additional sheet if necessary.
Full Name
Age
Relationship
College
Self (Student)
Susquehanna University
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