Dependent Verification Form - Financial Aid Office

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VERIFICATION WORKSHEET DEPENDENT STUDENTS
D
Southern Illinois University Carbondale
2015-16
D
VERIFICATION WORKSHEET
1263 Lincoln Drive – Mail Code 4702
Financial Aid Office, Student Services Building
DEPENDENT STUDENTS
F I N A N C I A L A I D O F F I C E
S T U D E N T S E R V I C E S B U I L D I N G
6 1 8 / 4 5 3 - 4 3 3 4
Carbondale, IL 62901
2015-16
M A I L C O D E 4 7 0 2
F A X : 6 1 8 / 4 5 3 - 7 3 0 5
618/453-4334 fax: 618/453-7305
1 2 6 3 L I N C O L N D R I V E
F A O @ S I U . E D U
fao@siu.edu
fao.siu.edu
C A R B O N D A L E , I L 6 2 9 0 1
F A O . S I U . E D U
The information you provided on your financial aid application must be verified before your financial aid eligibility can be evaluated.
Complete the applicable sections of this form and return it to the address listed above.
____________________________________________________
___________________________
_____________________________
Student's Name
Phone
Student ID Number (Dawg Tag)
____________________________________________________
___________________________
______
_____________________
Address
City
State
Zip Code
A. Family Information
In the “Full Name” column, list the people in your parent's household. Include yourself and your parents, (including a step parent).
Do not include foster children. Include your parents' other children if (a) your parents provide more than half of their support or (b) the
children would be required to provide parental information when applying for Federal Student Aid. Include 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, 2015 through June 30, 2016. (Support includes money, gifts, loans, housing, food, clothes, car, medical and dental care, payment of
college costs, etc.)
List the name of the college for family members who will be attending
college at least half-time between July 1, 2015 and June 30, 2016, and
Relationship to student
will be enrolled in a degree or certificate program. DO NOT LIST A
Full Name
Age
(parent, brother, sister, etc.)
COLLEGE FOR A PARENT. If the school uses clock hours, include
only students attending at least 12 clock hours per week.
Student
SIU
1.
2.
3.
4.
5.
6.
7.
[ ] Check this box if there are more than seven family members, and attach a list of these people.
B. Student's 2014 Income
For zero amounts, print a "0" in the blank.
[ ] Your completion of the FAFSA income section using the IRS Tax Retrieval Tool was successful, Skip this section and go to Section C below.
1.
[ ] If you will file a 2014 U.S. income tax return (Form 1040, 1040A, 1040EZ), you must send a signed copy of the IRS Federal Tax Return Transcript
to the SIU Financial Aid Office. Do not send your personal IRS Tax Return. Print the student's full name and Student ID Number (Dawg
Tag) on the copy.
Which of the following is true?
[ ] I have already sent a copy of my 2014 U.S. federal tax return transcript to the SIU Financial Aid Office.
[ ] I am mailing my signed 2014 U.S. federal tax transcript with this form.
[ ] I will not file a 2014 U.S. federal tax return.
2.
If you worked but did not file a 2014 U.S. federal tax return, list your employers and the amounts of income that you earned from work in 2014,
and submit all W-2 forms.
3.
EMPLOYER OR SOURCE OF TAXABLE INCOME FOR 2014
_________________________________________ $________________
_______________________________________ $________________
_________________________________________ $________________
_______________________________________ $________________
120
16017VFWDep: 1/16/15 151732

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