Independent Verification Worksheet for HSC Students

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1 16IVHP Independent Verificatin Wrksheet fr HSC Students Yur applicatin was selected fr review in a prcess called verificatin. In this prcess, Temple University will be cmparing infrmatin frm yur FAFSA applicatin with cpies f yur and yur spuse s 2015 Federal Tax Return Transcripts, W2 frms, r ther financial dcuments. The law states we have the right t ask yu fr this infrmatin befre awarding Federal aid. If there are differences between yur FAFSA applicatin infrmatin and yur financial dcuments, yu r Temple University may need t make crrectins electrnically r by using yur Student Aid Reprt (SAR). Cmplete this verificatin wrksheet and submit alng with all required dcuments t Student Financial Services (SFS) immediately, as Federal and/r University need-based aid awarded is estimated until this prcess is cmplete. Failure t cmplete verificatin in a timely manner may lead t cancellatin f aid. Upn review f the dcumentatin yu submit, additinal infrmatin may be required; ntificatin f such will be made as quickly as pssible and may necessitate checking yur Temple accunt. Yu will be ntified if FAFSA crrectins result in changes/cancellatin f award(s). 1. Submit the cmpleted Independent Verificatin Frm. Make sure the frm is SIGNED by the student. This frm is apprximately six pages and needs t be filled ut cmpletely. If the answer is zer r if the questin des nt apply t yu, write 0, d nt leave blank. 2. Submit 2015 IRS Tax Return Transcript(s) and W2 frms fr bth student (and spuse), if filed. As per federal regulatins, we can n lnger accept cpies f the filed federal tax return unless it is specifically requested by the SFS ffice. Yu can btain a Federal Tax Return Transcript by calling the IRS at r by visiting and clicking n the Get a Transcript f yur Tax Recrds link. Make sure t request the IRS Tax Return Transcript and NOT the IRS Tax Accunt Transcript. In mst cases, a 2015 IRS Tax Return Transcript may be requested as sn as the IRS prcesses the tax return. Generally, applicants shuld receive the transcript within 5 t 10 calendar days after their request (rdering nline will likely be faster than by mail r telephne). The best way t verify incme is by using the IRS Data Retrieval Tl (IRS DRT) that is part f FAFSA n the web at If yu reprted infrmatin fr Schedule C (Prfit r Lss frm Business), an IRS Tax Return Transcript will be required even with IRS Data Retrieval usage A. Independent Student s Infrmatin Student s Last Name Student s First Name Student s M.I. Student s Temple University ID# Student s Street Address (include apartment number) Student s Date f Birth City State Zip Cde Student s Phne # (include area cde)/cell

2 B. Independent Student s Family Infrmatin List belw the peple in yur husehld. Include: Yurself Yur spuse (if married) Yur children, if yu will prvide mre than half f their supprt frm July 1, 2016, thrugh June 30, 2017, r if the children wuld be required t prvide yur infrmatin if they were cmpleting a FAFSA fr Include children wh meet either f these standards (even if they d nt live with yu). Other peple if they nw live with yu and yu prvide mre than half f their supprt and will cntinue t prvide mre than half f their supprt thrugh June 30, If mre space is needed, attach a separate page with the student s name and TUID number at the tp. Full Name Age Relatinship Cllege Attending 7/1/16-6/30/17 Enrlled at least half-time? (Yes/N) Self Temple University C. Independent Student s Incme Infrmatin t Be Verified Check here if yu were nt married at the time yu filed the FAFSA. [Cmplete Sectin D] D. Unmarried Students (As f the time yu filed the FAFSA, even if yu are nw married) 1. Check nly ne bx belw. [Tax transcripts include the 2015 IRS tax return transcript frm filing Frm 1040, 1040A, 1040EZ, r a tax return frm Puert Ric. Tax transcripts can be btained by calling the IRS at , r by visiting Check here if yu successfully imprted 2015 IRS tax data using the IRS Data Retrieval Tl. Yu must still submit cpies f all W2 frms r ther earnings statements t SFS. Check here if yu are attaching yur 2015 tax transcript and W2 frm(s). Check here if yu earned incme, but did nt file a 2015 Federal Incme Tax Return, and have attached all 2015 W2 frm(s). If yu did nt file a 2015 Federal Incme Tax Return, but earned incme in 2015, yu must still prvide all W2 frms r ther earnings statements t SFS. Check here if yu did nt earn any wages r taxable incme in E. Married Students (As f the time yu filed the FAFSA, even if yu are n lnger married) Check here if yu successfully imprted 2015 IRS tax data using the IRS Data Retrieval Tl. Yu must still submit cpies f all W2 frms r ther earnings statements t SFS. Check here if yu are attaching yur and (yur spuse s) 2015 jint tax transcript and W2s. Check here if yu filed separately frm yur spuse and yu are attaching 2015 tax transcripts and 2015 W2s fr bth f yu. Check here if yu and/r yur spuse earned incme, but did nt file a 2015 Incme Tax Return. 2

3 If yu r yur spuse did nt file a 2015 Federal Incme Tax Return, but earned incme in 2015, yu must still prvide all W2 frms r ther earnings statements t SFS. Check here if yu and yur spuse did nt earn any wages r taxable incme in Emplyer Name/Surces f Incme Indicate Student r Spuse Incme 2015 Incme Earned F. Independent Student s Parent(s) Family Infrmatin List belw the peple in yur custdial parent(s) husehld. Include: Yurself and yur custdial parent(s) (including a stepparent) even if yu dn t live with yur parent(s). Yur custdial parent(s) ther children. If yur parent(s) will prvide mre than half f their supprt frm July 1, 2016, thrugh June 30, 2017, r if the ther children wuld be required t prvide parental infrmatin if they were cmpleting a FAFSA fr Include children wh meet either f these standards, even if they d nt live with yur parent(s). Other peple if they nw live with yur parent(s) and yur parent(s) prvide mre than half f their supprt and will cntinue t prvide mre than half f their supprt thrugh June 30, If mre space is needed, attach a separate page with the student s name and TUID number at the tp. Full Name Age Relatinship Cllege Attending 7/1/16-6/30/17 (excluding parents cllege) Enrlled at least half-time? (Yes/N) Self Temple University 3

4 G. Independent Student s Parent(s) Incme Infrmatin t Be Verified 1. Check nly ne bx belw. Tax transcripts include the 2015 IRS transcript frm filing Frm 1040, 1040A, 1040EZ, a tax return frm Puert Ric. Tax transcripts can be btained by calling the IRS at , r by visiting Check here if yu successfully imprted 2015 IRS tax data using the IRS Data Retrieval Tl. Check here if yu are attaching a cpy f yur IRS tax return transcript and 2015 W-2 frm(s). Check here if yu earned incme, but did nt file a 2015 Federal Incme Tax Return, and have attached all 2015 W2 frm(s). If yu did nt file a 2015 Federal Incme Tax Return, but earned incme in 2015, yu must still prvide all W2 frms r ther earnings statements t SFS. Check here if yu did nt earn any wages r taxable incme in Emplyer Name/Surces f Incme 2015 Incme Amunt H. Student, Spuse and Parent(s) Additinal Financial Infrmatin and Untaxed Incme Use the tables belw t reprt annual (nt mnthly) amunts. If the amunt is zer, r the questin des nt apply t yu, write 0. D nt leave items blank. This sectin is directly frm the FAFSA Additinal Financial Infrmatin PARENT(S) STUDENT S Child supprt paid because f divrce r separatin r as a result f a legal requirement. DO NOT include supprt fr children in parent s husehld. Grant and schlarship aid reprted t the IRS in yur adjusted grss incme. Includes AmeriCrps benefits (awards, living allwances and interest accrual payments), as well as grant and schlarship prtins f fellwships and assistantships (DO NOT include Temple University schlarships r grants) Untaxed Incme PARENT(S) STUDENT S Child supprt received fr all children in yur husehld. DO NOT include fster care r adptin payments. 4

5 Veterans nn-educatin benefits such as Disability Death Pensin r Dependency & Indemnity Cmpensatin (DIC) and/r VA Educatinal Wrk-Study allwances. Other untaxed incme nt reprted elsewhere n this frm, such as wrkers cmpensatin, disability, etc. Als include the Health and Savings accunt deductin frm IRS frm 1040, line 25. DO NOT include extended fster care benefits, student aid, earned incme credit, child tax credit, welfare payments, untaxed Scial Security benefits, Supplemental Security Incme, Wrkfrce Investment Act educatinal benefits, n base military husing r a military husing allwance, cmbat pay, (if yu are nt a tax filer), benefits frm flexible spending arrangements (e.g. cafeteria plans), freign incme exclusin r credit fr federal tax n special fuels Asset Infrmatin PARENT(S) STUDENT S As f tday, what is yur (and spuse s) ttal current balance f cash, savings and checking accunts? DO NOT include student financial aid. As f tday, what is the net wrth f yur (and spuse s) investments, including real estate? DO NOT include the hme yu live in r retirement accunts. Net wrth means current value minus debt. As f tday, what is the net wrth f yur (and spuse s) current businesses and/r investment farms? DO NOT include a family farm r family business with 100 r fewer full-time r full-time equivalent emplyees. I. Receipt f Supplemental Nutritin Assistance Prgram (SNAP) Benefits: (check ne bx belw) Check here if n member f the parents husehld (student, parent s children r ther individuals that live in the husehld and receive mre than half f the parent s supprt) received SNAP benefits in calendar year 2014 and/r Check here if a member f the parents husehld (student, parent s children r ther individuals that live in the husehld and receive mre than half f the parent s supprt) received SNAP benefits in calendar year 2014 and/r Please submit dcumentatin frm the agency that issued the SNAP benefits in 2014 and/r

6 J. Sign this Wrksheet Each persn signing this frm certifies that all the infrmatin reprted n it is cmplete and crrect. If married, spuse s signature is ptinal. Student Date WARNING: If yu purpsely give false r misleading infrmatin n this wrksheet, yu may be fined, be sentenced t jail, r bth. Spuse Date Parent Date K. Submit signed and cmpleted Independent Verificatin Wrksheet t the SFS ffice. SFS highly recmmends students uplad signed and cmpleted frms in the Student Tls tab f the TUprtal. It is fast & easy! Students may als mail r fax t the apprpriate SFS ffice: Temple University: HSC Campus Student Financial Services 3340 N. Brad St. Student Faculty Cnference Building, LB-41 Philadelphia, PA (phne) (fax) Temple University: Schl f Pdiatric Medicine Student Financial Services 8 th and Race Streets Philadelphia, PA (phne) (fax) Visit Student Financial Services n the web fr mre infrmatin, 6

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