V1 Dependent Verification Form

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2015-2016 VERIFICATION WORKSHEET (V1)
Dependent Student
UW-Platteville
What you should do
Your application was selected for review in a process called
1.
Fill out all sections of this form and return it to the UW-
“Verification.” In this process, UW-Platteville will be comparing
Platteville Financial Aid Office.
information from your FAFSA with you and your parent(s)’ 2014
2.
Submit all other required documents requested to the
Federal tax transcripts, or with W-2 forms or other financial
UW-Platteville Financial Aid Office.
documents. The law says we have the right to ask you for this
3.
The Financial Aid Office will compare information on
information before awarding Federal aid. If there are differences
this worksheet and any supporting documents with the
between your application information and your financial
information you submitted on your application. UW-
documents, we may need to make corrections electronically or
Platteville may need to make corrections electronically
by using your Student Aid Report (SAR).
or by using your SAR.
A. Student Information
Last Name
First Name
Social Security#
Date of Birth (mm/dd/yyyy)
Permanent Home Street Address
City
State
Zip Code
Cell Phone
Permanent Home Phone
Email Address
B. Family Information
1. List below the people in your parent(s)’ household. Include:
A. Yourself and your parent(s) (including a stepparent) even if you don’t live with your parent(s).
B. Your parent(s)’ other children if your parent(s) will provide more than half of their 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 they do not live with your parent(s).
C. Other people if they now live with your parent(s) and your parent(s) provide more than half of their support and will
continue to provide more than half of their support through June 30, 2016.
Full Name
Age
Relationship
Name of College/Degree Program (If at least half-time)
2015-2016
Self
UW-Platteville
2. Did anyone in your household receive child support in 2014? (Please check one) ____ Yes ____ No
*If yes please indicate total amount received in 2014 __________________ (Attach documentation of total received for each
recipient)
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