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Rev. 01-20212021-2022 Student Financial InformationYour 2021-2022 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. If there are differences, your FAFSA information may need to be corrected. You must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the Financial Aid Office at the address below. Student’s Information________________________________________________________________ ___________________________Student’s Last Name Student’s First Name Student’s M.I. Student’s SSN or Student ID ___________________________________________________________ ___________________________Student’s Street Address (include apt. no.) Student’s Date of Birth___________________________________________________________ ___________________________City State Zip Code Student’s Email Address___________________________________________________________ __________________________________Student’s Home Phone Number (include area code) Student’s Alternate or Cell Phone NumberStudent’s Income Information to Be Verified TAX RETURN NONFILERS—Complete this section if the student (and/or spouse, if married) will not file and is not required to file a 2019 income tax return with the IRS.Check the box that applies:4794252603500The student (and/or spouse, if married) was not employed and had no income earned from work in 2019.4794252603500The student (and/or spouse, if married) was employed in 2019 and has listed below the names of the entire student’s (and/or spouse’s, if married) employers. Attach copies of all 2019 IRS W-2 forms issued to the student (and/or spouse, if married) by employers or other earnings statements if available, i.e. 1099G (unemployment statement). List every employer even if they did not issue an IRS W-2 form. If more space is needed, attach a separate page with the student’s name and Social Security Number or SID at the top.Employer’s Name Suzy’s Auto Body Shop (example)1.4.2.5.3.6. Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2020 that indicates a 2019 IRS income tax return was not filed with the IRS or other relevant tax authority.48006012255500 Check here if 2019 Verification of Non Filing Tax Return was unable to be obtained from the IRS.353822095885WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.00WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.Certification and SignaturesI certify that all of the information reported on thisworksheet is complete and correct. The studentmust sign and date.__________________________________________________________________________________Student’s SignatureDate421830512700Submit this worksheet to the Financial Aid Office at:Gaston College201 Highway 321 SouthDallas, NC 2803400Submit this worksheet to the Financial Aid Office at:Gaston College201 Highway 321 SouthDallas, NC 280344813301206500483870546100gaston.edu00gaston.edu ................
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