V6- IND FORM 2015-2016 Independent Verification Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called Aggregate Verification. Northern is required to verify student and/or parent(s) income from work, non- filers information, SNAP (formally known a food stamps), child support, high school completion and educational identity for the 2015-2016 academic year as required by the U.S. Department of Education (34 CFR, Part 668). 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 spouse (if married) 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 spouse (if married). Your children or your spouse s children, even if they do not live with you, if you (or your spouse) will provide more than half of their financial support from July 1, 2015, through June 30, 2016) Other people if they now live with you and you 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 & SPOUSE TAX AND INCOME INFORMATION (All applicants) Instructions: You must provide your tax data. The preferred method is to utilize the IRS Data Retrieval Tool. If you have not already utilized the IRS Data Retrieval Tool, you can revise your FAFSA application to link your tax data to satisfy this requirement. If you filed your IRS tax return electronically, it is generally available to link to your FAFSA within 2-3 weeks of filing. If you mailed a paper copy of your IRS tax return, data is available for transfer 6-11 weeks after filing. If you are unable or choose not, to utilize the IRS Data Retrieval Tool within the FAFSA, you must submit a 2014 IRS Tax Return Transcript. To obtain your tax transcript, go to www.irs.gov and select the option to Order a Return Transcript. Note: only Return Transcripts will be accepted (not Account Transcripts). 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. TAX FILERS Check the box that applies: I and/or spouse filed a 2014 Federal Tax Return (form 1040, 1040A, 1040EZ) NON- TAX FILERS I, the student have used the IRS Data Retrieval Tool to retrieve and transfer 2014 IRS income information, either on the initial FAFSA or when making a correction to the FAFSA. The school will use the IRS information that was transferred in the verification process. I, the student have not yet used the IRS Data Retrieval Tool in the FAFSA, but will use the tool to retrieve and transfer 2014 IRS income information into the FAFSA, once I have filed a 2014 IRS tax return. See instructions above for information on how to use the IRS Data Retrieval Tool. The school cannot complete the verification process until the IRS information has been transferred into the FAFSA. I, the student am unable or choose not to use the IRS Data Retrieval Tool, and I will submit to the school a 2014 IRS tax return transcript. Make sure to request the IRS tax return transcript and not the IRS tax account transcript. See instructions above for information on how to use the IRS Data Retrieval Tool. The school cannot complete the verification process until the IRS information has been transferred into the FAFSA. Check here if an IRS tax return transcript(s) is attached to this worksheet. I am not required to file (and will not file) a 2014 Federal Tax Return. Were you employed or did you receive income from work in 2014? Yes / No (circle one) If you indicated Yes above, list below your employer(s) and the amount earned from each in 2014. If more space is needed please attach a separate paper with information. Student s name and ID must be included. Employer Name 2014 Amount Earned Note: Please attach a copy of any 2014 W- 2s provided by your employers listed above. 2
Student s Name: Student ID: STEP 4: UNTAXED INCOME STUDENT Answer each question below as it applies to you, the student, 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 paid or received the same dollar amount every month in 2014, multiply that amount by the number of months in 2014 you paid or received it. If you 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 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 C. Child support received Include cash payments and/or the cash value of benefits received by you the 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 D. Veterans non- education benefits List the total amount of veteran s non- education benefits by you, 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. 3
Name of recipient Type of veterans non- educational benefit STEP 5: OTHER UNTAXED INCOME List the amounts of other untaxed income received by you the student 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 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 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 2015-2016 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 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 and any members of the student 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: 4
STEP 6: 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 you (or spouse) if married 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 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 Signature Student ID 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 5