Parent Snap Verification Form - 2015-1016 printable pdf download

Office of Financial Aid

∘

P.O. Box 308 Notre Dame, IN 46556

financialaid@hcc-nd.edu

call:574-239-8400

fax:574.239.8323

SNAP Verification

Parent

COMPLETE ALL SECTIONS: Please complete the form in ink and print legibly

_________________________________________________________________

_____________________

Student’s Last Name

First Name

Middle Initial

Student ID Number

On the FAFSA, you reported that you, the parent, or other immediate family member in your household

received benefits from the Supplemental Nutrition Assistance Program (SNAP or Food Stamps) in 2013 or

2014. Holy Cross College is required by federal regulations to confirm this information in order to complete

your student’s financial aid file.

The parents certify that _______________________________________, a member of the parents’ household,

received benefits from the Supplemental Nutrition Assistance Program or SNAP (formerly known as the Food

Stamp Program) sometime during 2012 or 2013. SNAP may be known by another name in some states. For

assistance in determining the name used in a state, please call 1-800-4FED-AID (1-800-433-3243).

The parents’ household includes:

 The student.

 The parents (including a stepparent) even if the student doesn’t live with the parents.

 The parents’ other children if the parents will provide more than half of the children’s support from July

1, 2015, through June 30, 2016, or if the other children would be required to provide parental

information if they were completing a FAFSA for 2015–2016. Include children who meet either of these

standards even if the children do not live with the parents.

 Other people if they now live with the parents and the parents provide more than half of the other

people’s support and will continue to provide more than half of their support through June 30, 2015.

Note: If we have reason to believe that the information regarding the receipt of SNAP benefits is inaccurate, we

may require documentation from the agency that issued the SNAP benefits in 2013 or 2014.

By signing this form, I certify the information on this form and any attachments are accurate and complete to the best of my

knowledge. If requested, I agree to provide documentation to support the information I have provided on this form. I understand that

any false statements or misrepresentation may be cause for denial, reduction, withdrawal, and/or repayment of financial aid, and I may

be subject to a fine, imprisonment or both, under provisions of the United States Criminal Code.

_________________________________________

______________________

Parent Signature

Date

2015-2016

Parent Snap Verification Form - 2015-1016