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60737759525002020-2021 Other Income InformationYour application was selected for a review process called “Verification”. Young Harris College (YHC) will compare information from your 2020-2021 Free Application for Federal Student Aid (FAFSA) with this worksheet and other documents, as requested. The law requires us to ask for this information before disbursing federal aid. If there are differences between your application information and the documents, YHC will make corrections to your FAFSA. A. STUDENT INFORMATIONStudent’s Name:YHC ID: Or last 4 of SSN:Street Address (include apt. #):City/State/Zip:Date of Birth:Phone:Email:Note: Communications regarding this request will be sent via email to the student’s YHC email address.B. dependency statusCHECK ONE. What is your dependency status in the 2020-2021 FAFSA?? DEPENDENT STUDENT – You are REQUIRED to provide parental information on your FAFSA. BEFORE BEGINNING THIS WORKSHEET: Did you provide duplicate tax or income information for Student and Parent(s) on FAFSA?YES: Correct the tax and/or income items, re-sign, and resubmit the FAFSA. Our office will contact you if anything else is needed.NO: Answer ALL of the questions in Section C and D regarding income situations which may have been reported for you or your parent(s) on FAFSA. If the parent on your FAFSA is remarried, step-parent information is also required.? INDEPENDENT STUDENT – You are NOT REQUIRED to provide parental information on your FAFSA.Answer ALL of the questions in Section C and D regarding income situations which may have been reported for you or your Spouse (if married) on the FAFSA. 2018 OTHER INCOMEAnswer ALL of the following questions. If a question does not apply, enter $0. Do not leave any dollar amount blank. The 2018 income information provided below is for: ? PARENT(S) ? STUDENT (& Spouse, if married)A SIGNED copy of the 2018 IRS tax return(s) and applicable schedule(s) for the individual(s), above, are: ? Attached ? Will be provided later2018 Education Credits American Opportunity Tax Credit and Lifetime Learning Tax Credit from IRS Form 1040-Line 50 or 1040A-Line 33.$2018 Taxable Earnings from Need-Based Employment Programs Examples: Federal Work-Study, need-based employment portions of fellowships and assistantships. $2018 Taxable College Grant and Scholarship Aid Only include amounts reported to the IRS as a deduction calculated into Adjusted Gross Income on 2018 taxes. This is NOT a scholarship offer that YHC will offer, whether merit or need-based.$2018 Combat Pay or Special Combat Pay Only enter the amount that was taxable and included as a deduction in adjusted gross income on 2018 taxes. Do not enter untaxed combat pay, which would be reported on the W-2.$2018 Earnings from Work under a Cooperative Education Program Also known as co-ops, this may be offered by a College while working in an experiential learning environment outside of a classroom$D. 2018 child support paidDEPENDENT Student- Complete this section if your Parent paid child support for a dependent whom the Parent does not have primary custody. This may be a court order as a result of a divorce or separation. Enter $0 in the total box if no child support was paid.INDEPENDENT Student- Complete this section if you or your Spouse (if married) paid child support for a dependent whom you or your Spouse (if married) does not have primary custody. This may be a court order as a result of a divorce or separation. Enter $0 in the total box if no child support was paid.CHECK ONE: The child support information provided below is for: ? PARENT(S) ? STUDENT (& Spouse, if married)Name of Person WhoPaid Child SupportName of Person to WhomChild Support Was PaidName of Child for WhomSupport Was PaidDoes Child reside in samehousehold as person in first column?Amount of Child SupportPaid in 2018Total paid for all children in 2018$E. CERTIFICATION & SIGNATURE(S) – REQUIREDElectronic signatures cannot be accepted.5459730447675WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sent to prison, or both.00WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sent to prison, or both.Each person signing below certifies that the all of the information reported is complete and correct. I have attached the REQUIRED SIGNED 2018 IRS tax return(s) and applicable schedules. If dependent, the student and one parent whose information was reported on the FAFSA must sign and date. Student signature _______________________________________ Date ____/____/____Parent signature ________________________________________ Date ____/____/____(Required if parent information was reported on the FAFSA) ................
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