Verification Form 2016-2017

Verification Form 2016-2017

Página | 3/1

VERIFICATION FORM 2016-2017

STANDAR VERIFICATION

Your Free Application for Federal Student Aid (FAFSA) was selected for verification by the Department of Education. Federal Regulation provides that prior to indict the financial aid must ask you to confirm the information that you or your parents reported on the FAFSA. You must complete this sheet Verification and include any document that is required by the institution.

Select one of the following options, according to the information in your Free Application for Federal Student Aid (FAFSA)

ADVERTENCIA

Si usted a propósito provee información errónea o falsa, puede ser sentenciado(a) a prisión, multa o ambas.

Revisado 01/2012

Página | 3/1

  1. STUDENT INFORMATION

______

Last name First name Initial Student ID Number

  1. HOUSEHOLD INFORMATION AND POSTSECINDARY STUDENTS

Include the information requested of you and those family members who live with you, who will attend a postsecondary institution and who receive or will provide more than half of their support and will continue receiving or providing from 1 July 2016 to 30 June 2017.

Complete Name / Age / Relationship / College or University / Is enrolled at least half time
Yes / No
  1. STUDENT INCOME INFORMATION AND/OR PARENTS NO RETURNS

Section 1: If you and / or parents file income tax return

Student / Parent
  • Include signed copy of Form Income Tax Puerto Rico.

  • Filing Federal Payroll (IRS), and the tool used information retrieval (IRS) to transfer income information on the FAFSA.

  • Enclose certified copy of the Federal Form (IRS), because I could not or did not want to use the recovery tool information (IRS) to transfer income information to the FAFSA copy.

Section 2: If you and / or parents do not file income tax returns

Student / Parent
  • I was unemployed and had no income from work in 2015.

  • I work income in 2015, but I am not required by law to file the Income Tax Return. (If you checked this option you must complete the information in the table below).

Employer Name / Income for 2015 / Attached IRS or W-2
Yes / No
  1. Other benefits and/or income received in the home including non-veterans education benefits

Recipient’s Name / Type of Benefit or Income Received in 2015 / Amount of benefits or income received in 2015
  1. Money received or paid on behalf of students:

Purpose
Example: Money received in cash (family support, rent, books, etc. / Amount of benefits received in 2015 / Source
  1. STUDENT INFORMATION AND/OR PARENTS TO BE VERIFIED SNAP

? Have you or any member of your household receives benefits from the Supplemental Nutrition Assistance Program (SNAP) for the Year 2015?

YES NO

  1. STUDENT INFORMATION AND/OR PARENTS TO BE PAID BOARD VERIFIED

¿You, your spouse or your parents pay alimony during 2015?

YES NO

Name of individual
paying the pension / Name of individual
who is paying the pension / Name of children
They are receiving the pension / Annual amount
  1. SIGNATURES AND CERTIFICATION

I certify that all information contained in this document is accurate and complete.

______

Student signature Student ID number

The signature of parent or guardian is required only if you checked dependent. I certify that all information contained in this document is accurate and complete.

______

Signature of Parent or Guardian Date

______

Print name of Parent or Guardian Relationship

Warning: If you deliberately provides misleading or false information may be sentenced (a) to imprisonment, fine or both.

ADVERTENCIA

Si usted a propósito provee información errónea o falsa, puede ser sentenciado(a) a prisión, multa o ambas.

Revisado 01/2012

Top View