V1-Standard Financial Aid Verification Worksheet For Independent Students Page 3

G. Other Untaxed Income to Be Verified (i.e., in-kind assistance, child support received, Social Security/Disability,

Non-educational military benefits)

Benefits received in 2012 and/or 2013

Amount Received

REQUIRED SIGNATURES

: I/we certify that all information reported on this form is complete and correct.

Warning: If you purposely give false or misleading information on this form, you may be fined, sentenced to jail, or

both.

_________________________________________________

____________________________________________

Student’s Signature

Date

Spouse’s Signature (optional)

Date

Submit this worksheet to: Atlanta Technical College Office of Financial Aid, 1560 Metropolitan Parkway, SW Atlanta, GA

30310 Email: financialaid@atlantatetch.edu; Fax: 404.225.4721

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