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Reinhardt University

2019-2020 Independent Verification Worksheet

|Your 2018-2019Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. By law, we need to confirm the information you |

|reported on your FAFSA before awarding federal aid. The financial aid administrator will compare your FAFSA with the information on this worksheet and with any other |

|required documents. If there are differences, your FAFSA information may need to be corrected. |

A. Student’s Information

______________________________________________________________ ___________________________________

Student’s Last Name Student’s First Name Student’s M.I. Student’s Social Security Number

______________________________________________________________ ___________________________________

Student’s Street Address (include apt. no.) Student’s Date of Birth

______________________________________________________________ ___________________________________

City State Zip Code Student’s Phone Number

B. Student’s Family Information

What is your current marital status?

□ Married □ Never Married □ Divorced □ Separated □ Widowed

If applicable, list the month and year you were married, divorced, separated or widowed: _____________________

C. Household Information

List below the people in your household. Include:

▪ Yourself

▪ Your spouse (if married)

▪ Your children if you will provide more than half of their support from July 1, 2019 through June 30, 2020 or if they would be required to provide parental information if they were completing a FAFSA for 2019-2020(do not include children for whom you are paying child support).

▪ 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, 2020.

If dependents listed below will be enrolled at least half time in a degree, diploma or certificate program at a postsecondary educational institution any time between July 1, 2019 and June 30, 2020, please complete the information in columns four and five. If they will not be attending college in the 2019-2020 please leave columns four and five blank.

|1. Full Name |2. Age |3. Relationship |4. College Attending |5. Will be Enrolled at |

| | | |in 2019-2020 |Least Half Time |

|Missy Jones (example) |18 |Sister |Reinhardt University |Yes |

| | |Self | | |

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D. Student’s Income Information

The STUDENT (and spouse) filed or will file a 2017 IRS federal income tax return:

□ Yes

• You will need to use the IRS Data Retrieval Tool in FAFSA on the Web to import tax information onto FAFSA OR

• You will need to order a Tax RETURN Transcript from the IRS () to submit with this form (if married but filing separately we will need one for both you and your spouse).

□ No, because the student (and spouse) either □ Did not work in 2017 OR □ Was employed but is not required to file – complete table below

(Must order Verification of Non-Filing Letter from IRS using IRS Form 4506T)

|Employer’s Name |2017 Amount Earned |IRS W-2 Attached? |

|Suzy’s Auto Body Shop (example) |$2,000.00(example) |Yes(example) |

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E. Child Support Paid

Did you (or your spouse) PAY child support to someone else in 2017?

□ Yes- complete table below □ No- skip to Section F

|Name of Person Who Paid Child |Name of Person to Whom Child Support was |Name of Child for Whom Support Was Paid|Amount of Child Support Paid in |

|Support |Paid | |2017 |

|Marty Jones(example) |Chris Smith (example) |Terry Jones (example) |$6,000.00(example) |

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F. Certification and Signatures

Each person signing this worksheet certifies that all of the

information reported on it is complete and correct.

The student and spouse, if applicable, must sign and date.

_________________________________________________ _________________________________

Student’s Signature Date

_________________________________________________ _________________________________

Spouse’s Signature Date

Please mail, fax or email to:

Reinhardt University, Office of Financial Aid, 7300 Reinhardt Circle, Waleska, GA 30183

FAX 770-720-9126

Email: financialaid@reinhardt.edu

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WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.

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