2016-2017 Verification Worksheet Independent Student
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32016–2017 Verification Worksheet
Independent Student
Your 2016–2017 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.
A. Independent Student’s Information
_____________________________________________________________
____________________________________
Student’s Last Name
Student’s First Name
Student’s M.I.
Student’s Social Security Number
_____________________________________________________________
____________________________________
Student’s Street Address (include apt. no.)
Student’s Date of Birth
_____________________________________________________________
____________________________________
City
State
Zip Code
Student’s Email Address
_____________________________________________________________
____________________________________
Student’s Home Phone Number (include area code)
Student’s Alternate or Cell Phone Number
B. Independent Student’s Family Information
List below the people in your household. Include:
Yourself.
Your spouse, if you are married.
Your children, if any, if you will provide more than half of their support from July 1, 2016, through June 30, 2017, or if
the child would be required to provide your information if they were completing a FAFSA for 2016–2017. Include
children who meet either of these standards, even if they do not live with you.
Other people if they now live with you and you provide more than half of their support and will continue to provide more
than half of their support through June 30, 2017.
Include the name of the college for any household member who will be enrolled at least half time, in a degree, diploma, or
certificate program at a postsecondary educational institution any time between July 1, 2016, and June 30, 2017. If more space
is needed, attach a separate page with your name and Social Security Number at the top.
Full Name
Age
Relationship
College
Will be Enrolled at
Least Half Time
Marty Jones(example)
28
Wife
Central University
Yes
Self
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