SJFC Dependent Verification Worksheet

Financial Aid Office
2014-2015 VERIFICATION WORKSHEET
For Dependent Student
Your Financial Aid application has been selected for a process called “Verification.” In this process, St. John Fisher College will be
confirming information on your FAFSA. We cannot continue processing your financial aid or any appeal until we have complete and
correct information. Please submit all required documents to the Financial Aid Office promptly.
A. Student Information
Name:____________________________________________ Student ID: @__________________
Email:________________________________ Daytime/Cell Phone Number:____________________
B. Tax and Income Information
Choose 1 of the 4 options listed below for BOTH the student and the parent(s). Include any documentation listed with the
chosen option. See below for information on the *IRS Data Retrieval tool and requesting **IRS Tax Return Transcripts.
(Note: Schedule C, Schedule F, and/or K-1’s may be required)
Student (Choose one of the below options)
 I earned $0 income from work in 2013 and did not file a tax return.
 I worked in 2013 but was not required to file a tax return. I earned $___________ in wages. Attached are my W-2(s).
 I filed a tax return in 2013 AND used the *IRS Data Retrieval tool on ________ (approximate date). Attached are my W-2(s).
 I filed a tax return in 2013 BUT DID NOT or COULD NOT use the IRS Data Retrieval tool.
Attached is my **IRS Tax Return Transcript and my W-2(s) for 2013.
Parent(s) (Choose one of the below options)
 My parent(s) earned $0 income from work in 2013 and did not file a tax return. They received support from _________________.
 My parent(s) worked in 2013 but was (were) NOT required to file a tax return. They earned $__________ in wages.
Attached are my parents W-2(s).
 My parent(s) filed a tax return in 2013 AND used the *IRS Data Retrieval tool on______ (approximate date).
Attached are their W-2(s).
 My parent(s) filed a tax return in 2013 BUT DID NOT or COULD NOT use the IRS Data Retrieval tool.
Attached is my Parent(s) **IRS Tax Return Transcript(s) and my parent(s) W-2(s) for 2013.
*The IRS Data Retrieval tool can be used to electronically link your tax return information onto your FAFSA. This process is
available two weeks after your return has been processed by the IRS. Retrieval can be completed by logging back into your FAFSA at
www.fafsa.gov and selecting “Make a Correction.” Please make sure to fully resubmit the FAFSA to ensure processing of the correction.
Additional detailed steps on completing this process can be found at www.sjfc.edu/financialaid.
**IRS Tax Return Transcripts (not to be confused with Tax Account Transcripts) can be requested in four ways:
1.) Request online at www.irs.gov/Individuals/Get-Transcript.
 Download an electronic copy of your Tax Return Transcript directly from the IRS website.
o Select the option to “Get Transcript Online” on the IRS website.
 Request a paper copy to be mailed in 7 – 10 business days.
2.) Request by phone at 1-800-908-9946.
3.) Complete and mail IRS Form 4506T-EZ (available through www.irs.gov).
4.) Visit your local IRS office and present photo identification.
C. Child Support Paid in 2013 (Note: If you received child support rather than paid child support, the amount will be listed in
Section F.) Please indicate “0” or “N/A” below if Child Support Paid is not applicable.
Name of person(s) listed in the
household who paid support
Person(s) to whom Child Support
was paid
Annual Amount of
Child Support Paid
Name(s) of Children for whom Child
Support was paid
D. Rollover
Please list the total amount of any rollovers included on your tax return as part of IRA Distributions (line 15a) and/or Pensions (line 16a) on
the Federal 1040 Income Tax Return. If none, please indicate “0” or “N/A” : $_____________.
3690 East Avenue  Rochester, NY 14618  585-385-8042  Fax 585-385-8044  [email protected]
Student ID #___________________________
E. Family Information
List the people in your parent’s household, include:
 Yourself and your parent(s) (including stepparent) even if you don’t live in the same residence as your parent(s), and
 Your parent’s other children, even if they don’t live with your parent(s) IF (a) your parent(s) will provide more than half of their
support from July 1, 2014 through June 30, 2015, or (b) the children would be required to provide parental information when
applying for Federal Student Aid, and
 Other people if they now live with your parent(s) and your parent(s) provide(s) more than half of their support and will continue to
provide more than half of their support from July 1, 2014 through June 30, 2015.
Also, write in the name of the college for any household member, excluding your parent(s), who will be enrolled at least half-time between
July 1, 2014 and June 30, 2015 in a degree, diploma, or certificate program at a Title IV eligible institution. If more space is needed, attach a
separate sheet.
Full Name
Age
Relationship
College (if applicable)*
Self
St. John Fisher College
*Please Note: If you have indicated more than one in college, enrollment verification may be required.
F. Additional Financial Information and Untaxed Income
(Please do not leave blanks; use “0” or “N/A” if not applicable.)
Source of 2013 Income Exclusions
Taxable earnings from Federal Work Study
Student grant and scholarship aid reported in your adjusted gross income
Taxable combat pay or special combat pay included in your adjusted gross income
Earnings from work under a cooperative education program offered by a college
(Questions 44 & 93 of the FAFSA)
Amount paid to
Student
Amount paid to
Parent/Stepparent
$
$
$
$
$
$
XXX
$
(Questions 45& 94 of the FAFSA)
Sources of 2013 Untaxed Income
Child support received for all children for 2013
Living allowances paid to members of the military, clergy and others
Veterans noneducation benefits
Any *other untaxed income or benefits, such as workers’ compensation, disability,
first time homebuyer credit, etc…
Money received, or paid on your behalf (e.g., bills), not reported elsewhere on this
form
Amount paid
to Student
XXX
$
$
$
$
Amount paid to
Parent/Stepparent
$
$
$
$
XXX
*Other untaxed income does NOT include student aid, earned income credit, additional child tax credit, welfare payments, untaxed Social Security benefits,
Supplemental Security Income, Workforce Investment Act educational benefits, combat pay, on-base (or any) military housing allowance, benefits from flexible
spending arrangements (e.g., cafeteria plans) foreign income exclusion or credit for federal tax on special fuels.
G. Sign this Worksheet
By signing this worksheet, we certify that all the information reported on this worksheet is complete and correct. We further
understand that purposely giving false or misleading information on this worksheet may lead to fines, jail sentences, or both.
___________________________
_______
_____________________________
_______
Student Signature
Date
Parent/Stepparent Signature
Date