Frostburg State University Office Of Student Financial Aid

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Office of Student Financial Aid
2011-2012 Dependent Verification Worksheet
Student’s Name: _______________________ SSN: ________ - _____ - ________ ID: ____________
Date of Birth: ___/___/_____ Ph: Home: _____________ Cell: _____________ Local: _____________
Your financial aid application was selected for review in a process called “Verification”. The U.S. Department of Education
requires that colleges check the accuracy of the information that you provided on the 2011-2012 Free Application for Federal
Student Aid (FAFSA) or the Renewal Application. We will be comparing information from your application with signed copies
of you and your parent(s) 2010 Federal tax forms. Please complete this form, attach the appropriate documentation, and return it
to the Office of Student Financial Aid as soon as possible. If there are any questions left blank, this form will be returned to you
and it may delay your financial aid award. We may need to contact you, if we have questions concerning your answers.
**PROCESSING OF YOUR AID HAS STOPPED UNTIL THIS FORM AND ALL REQUESTED
DOCUMENTS ARE RETURNED**
SECTION A: HOUSEHOLD INFORMATION
List the people in your parents’ household, include:
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 provide more than half of
their support from July 1, 2011 through June 30, 2012, or (b) the children would be required to provide parental
information when applying for Federal Student Aid, and
DO NOT INCLUDE Legal Guardians or other relatives as your parents. Please contact our office, if you fit this criterion.
Also write in the name of the college for any household members, excluding your parents, who will be attending college at
least halftime between July 1, 2011 and June 30, 2012.
Name of Family Member
Age
Relationship
College
Self
Frostburg State University
SECTION B: PARENTS’ 2010 TAX INFORMATION
Please list the total wages earned by each parent in 2010 (from January 1, 2010 through December 31, 2010)
Employer
Wages earned in 2010
Father(Stepfather):
$
Mother (Stepmother) :
$
Check one box only:
Check and attach SIGNED 2010 Federal tax return(s). (State tax returns or W2’s are not acceptable)
You must submit a copy of your parents’ 2010 Federal tax return. If your parent(s) did not keep a copy of the tax return,
request a copy from the tax preparer or a copy from the internal revenue service at (800) 829-1040.
Acceptable Federal Tax return(s) 1040 EZ, 1040A, 1040, or Form 1722, or RTFTP from IRS - we are NOT able to
accept Form 8453 – U.S. Individual Income Tax Declaration Form.
If an amended tax return was filed, you must submit copies of both the amended tax return AND the original.
Signatures are required on all tax forms.
See Section D
Check here if your parent(s) will not file and are not required to file a 2010 Federal Income Tax Return.

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