V6- DEP FORM 2015-2016 Dependent Verification Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. Northern must compare information from your FAFSA with information you provide on this worksheet and with any other required documents. If there are differences, Northern s Financial Aid Office could require additional documentation and/or your FAFSA information may need to be corrected. You will not receive federal financial aid until all verification requirements are met and the necessary, if any, corrections are made. To verify that accurate information was provided on your application, we will compare your FAFSA with the information on this document and with any other required documents. Northern New Mexico College reserves the right to make all necessary changes to your Student Aid Report. If you have questions about the verification process, please contact the Financial Aid Office at (505) 747-2128 or finaid@nnmc.edu. Failure to complete the verification process will result in a delay of financial aid processing or possible loss of eligibility. You and your parent(s) must complete and submit this Verification Form, and any additional documentation requested, before your financial aid will be processed. STEP 1: STUDENT INFORMATION Last Name First Name M.I. Student ID Address (where you get your mail) Date of Birth City State Zip Email Phone OR Message Phone Cell Phone STEP 2: FAMILY INFORMATION List below the people in your household. If more space is needed, provide a separate paper that includes student name and ID on the top of page. Include: Yourself and your parent(s) (including a stepparent) even if you don t live with your parent(s). 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). 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 College Will be Enrolled at Least Half Time? 1. Self Northern 2. 3. 4. 5.
Student s Name: Student ID: STEP 3: STUDENT INCOME INFORMATION Are you or will you be required to file a 2014 Federal Income Tax Return? The best way to verify income is by using the IRS Data Retrieval Tool that is part of FAFSA on the Web. If you have not already used the tool, go to FAFSA.gov, log into the student s FAFSA record, select Make FAFSA Correction and navigate to the Financial Information section of the form. From there, follow the instructions to determine if you are eligible to use the IRS Data Retrieval Tool to transfer 2014 IRS income tax information into the student s FAFSA. It takes up to 2 weeks for IRS income information to be available for the IRS Data Retrieval Tool for electronic IRS tax return filers, and up to 8 weeks for paper IRS tax return filers. Need Assistance? Step- by- step instructions for completing the IRS Data Retrieval or obtaining your IRS Tax Transcript are available at www.nnmc.edu, Financial Aid section. Click on How to Apply for Financial Aid. Check the box that applies: I used the IRS Data Retrieval Tool in FAFSA- on- the Web to transfer 2014 IRS income tax information into my FAFSA. (The income tax information, from your FAFSA will be used to complete the verification process.) I did not (or could not) transfer my 2014 income information to FAFSA using the IRS Data Retrieval Tool. I have attached a copy of my 2014 IRS Tax Return Transcript to this worksheet. I have not filed and am not required to file a 2014 income tax return and I had no income earned from work in 2014. I have not filed and am not required to file a 2014 federal income tax return, but I had income earned from work in 2014 as listed below. (List every employer and the amount earned in 2014, even if they did not issue an IRS Form W- 2. Attach copies of all 2014 IRS Forms W- 2 that were issued to you by employers.) Employer Name 2014 Amount Earned 2014 IRS Form W2 Attached STEP 4: PARENT(S) INCOME INFORMATION NOTE: Provide the requested income information for each parent/stepparent listed in STEP 2 of this worksheet. Notify your Financial Aid Office if your parent(s) had a change in marital status after December 31, 2014 or if your parent(s) filed or will file an amended 2014 IRS tax return. Need Assistance? Step- by- step instructions for completing the IRS Data Retrieval or obtaining your IRS Tax Transcript are available at www.nnmc.edu, Financial Aid section. 2
Student s Name: Student ID: Check the box that applies: The parent(s) used the IRS Data Retrieval Tool in FAFSA- on- the Web to transfer 2014 IRS income tax information into my FAFSA. (The income tax information, from your FAFSA will be used to complete the verification process.) The parent(s) of the student did not (or could not) transfer their 2014 income information to FAFSA using the IRS Data Retrieval Tool. The parent(s) have attached a copy of their 2014 IRS Tax Return Transcript to this worksheet. (Note: If your parents filed a joint tax return, but you reported your parent s marital status on the FAFSA as separated, divorced or widowed, you must include copies of all IRS Form W- 2s with the tax transcript.) The parent(s) of the student have not filed and are not required to file a 2014 federal income tax return and they had no income earned from work in 2014. The parent(s) of the student have not filed and are not required to file a 2014 federal income tax return, but they had income earned from work in 2014 as listed below. (List every employer and the amount earned in 2014, even if they did not issue an IRS Form W- 2. Attach copies of all 2014 IRS Forms W- 2 that were issued to you by employers.) STEP 5: UNTAXED INCOME STUDENT/PARENT(S) Answer each question below as it applies to you, the student, and the parent(s) whose information is reported on the FAFSA. If any item does not apply, enter N/A for Not Applicable where a response is requested, or enter 0 in an area where an amount is requested. To determine the correct annual amount for each item: If you or your parent(s) paid or received the same dollar amount every month in 2014, multiply that amount by the number of months in 2014 you or your parent(s) paid or received it. If you or your parent(s) did not pay or receive the same amount each month in 2014, add together the amounts you paid or received each. A. Payments made by student and/or parents to tax- deferred pension and retirement savings plans. List any payments (direct or withheld from earnings) to tax- deferred pension and retirement savings plans (e.g., 401(k), or 403(b) plans), including, but not limited to, amounts reported on W- 2 forms in Boxes 12a, through 12D with codes D, E, F, G, H, and S. Name of person who made the payment Total Amount Paid 2014 B. Child support received List the actual amount of any child support for ALL children listed in the household in STEP 2 of this worksheet. Do not include foster care payments, adoption payments, or any amount that was court- ordered but not actually paid. Name of person who received child support Name of child for whom support was received Amount of child support 3
C. Housing, food, and other living allowances paid to member of the military, clergy, and others. Include cash payments and/or the cash value of benefits received by student or student s parent(s). Do not include the value of on- base military housing or the value of a basic military allowance for housing. Name of recipient Type of benefit Amount of benefit D. Veterans non- education benefits List the total amount of veterans non- education benefits by you or your parent(s). Include Disability, Death Pension, Dependency and Indemnity Compensation (DIC) and/or VA Educational Work Study allowances. Do not include federal educational benefits such as Montgomery GI Bill, Dependent Education Assistance Program. VEAP Benefits, Post- 911 GI Bill. Name of recipient Type of veterans non- educational benefit Amount of benefit STEP 6: OTHER UNTAXED INCOME List the amounts of other untaxed income received by you or the student parent(s) that were not reported elsewhere on this form. Include untaxed income such as workers compensation, disability, Black Lung Benefits, untaxed portion of health savings accounts from IRS Form 1040 Line 25, Railroad Retirement Benefits, etc. Do not include student aid, Earned Income Credit, Additional Child Tax Credit, Temporary Assistance to Needy Families (TANF), untaxed Social Security Benefits, Supplemental Security Income (SSI), Workforce Investment Act (WIA) educational benefits, combat pay, benefits from flexible spending arrangements (e.g., cafeteria plans), foreign income exclusion, or credit for federal tax on special fuels Name of recipient Type of other untaxed income Amount of benefit A. Money received or paid on the student s behalf List any cash support received or paid on the student s behalf (e.g., payment of student s bills) and not reported elsewhere on this form. If someone is paying rent, utility bills, etc., for the student or gives cash, gift cards, etc., include the amount of that person s contributions. DO NOT INCLUDE SUPPORT FROM A PARENT WHOSE INFORMATION WAS ALREADY REPORTED ON THE 2014-2015 FAFSA. Amounts paid on the student s behalf also include any distributions to the student from a 529 plan owned by someone other than the student or the student s parent(s), such as grandparents, aunts, and uncles of the student. Name of recipient Type of financial support Amount of benefit 4
B. Additional Information So that we can fully understand your family financial situation, please provide information about any other resources, benefits, and other amounts received by the student, parent(s) and any members of the student s, or parent(s) household. This may include items that were not required to be reported on the FAFSA or other forms submitted to the Financial Aid Office, and include such things as federal veteran s education benefits, military housing, SNAP, TANF, SSI, WIC etc. Name of recipient Type of financial support Amount Comments: STEP 7: OTHER INFORMATION TO BE VERIFIED A. Food Stamp Benefits Calendar Year 2013-2014 Complete this section if one of the persons listed in STEP 2 received benefits from the Supplemental Nutrition Assistance Program or SNAP (formally known as food stamps) any time during the 2013 and/or 2014. Yes One of the persons listed in STEP 2 of this worksheet received SNAP benefits in 2013 and/or 2014. If asked by Northern s Financial Aid Office, I will provide documentation of the receipt of SNAP benefits. No Continue to Section B NOTE: If NNMC has reason to believe that the information provided regarding the receipt of SNAP benefits is inaccurate, we may require documentation from the agency that issued the SNAP benefits in 2013 or 2014. B. Child Support Paid Did one Did one (or both of the student s parent(s) listed in STEP 2 pay child support in 2014 Yes I/we paid child support in 2014 and have listed below the requested information for each child to whom child support was paid. If asked by Northern s Financial Aid Office, I/we will provide additional documentation of the payment of child support. (Do not include child support paid for children listed on your FAFSA as part of your household size or listed in STEP 2 of this worksheet.) No Continue to Step 8 Name of person who paid child support Name of person to whom child support was paid Amount child support paid in 2014 5
STEP 8: CERTIFICATION and SIGNATURES We certify that all the information reported on this worksheet is complete and correct. The student must sign and date this worksheet. If student is married, the spouse s signature is optional. WARNING: If you purposely give false or misleading information on this form, you may be fined, be sentenced to jail or both. Student Name Student ID Student Signature Date Parent Signature Date Do not mail this worksheet to the U.S. Department of Education. Submit this worksheet along with all required documentation to Northern s Financial Aid Office. You should make a copy of this worksheet and all submitted documents for your records 6