Tel: 1-(855)286-3462(FINA)
Fax: (706) 756-4635
Email: FinancialAid@westgatech.edu
Office of Student Financial Aid
1 College Circle  LaGrange, GA 30240
www.westgatech.edu/fa/index.htm
2015-2016 VERIFICATION WORKSHEET
Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. If
information on your FAFSA is incorrect we might need to make corrections. Corrections might alter your financial aid eligibility.
Complete this verification form and submit it with all required financial documents as soon as possible to the Financial Aid Office.
www.westgatech.edu/fa/index.htm
Please make sure you read and understand all items you are completing and if necessary, review your completed FAFSA. Incomplete
documents will delay processing. Please allow 4-6 weeks processing time before awards can be viewed on your Self- Service Banner
Web account. Complete your file prior to the semester deadlines to ensure available funding at the start of the term.
Section A: Student Information
Last Name
First Name
MI
Street Address (include apt. no.)
ID #/Social Security #
Date of Birth
City
State
Zip Code
Phone Number (with area code)
Section B: Family Information
INDEPENDENT STUDENTS
(You were not required to provide parental data
on the FAFSA)
Include: yourself, your spouse, your children, and any other person if they meet the
following criteria:




they now live with you, and
you provide more than half of their support, and
you will continue to provide this support between July 1, 2015 and June 30, 2016.
Also list the name of the college for any household member who will be enrolled at least
half-time in a postsecondary school between July 1, 2015 and June 30, 2016.
If more space is needed, attach a separate page with your name and student ID at the top.
DEPENDENT STUDENTS
(Your parent information was required on the
FAFSA)
Include: yourself and your parents/stepparents, and any other person if they meet
the following criteria:



they now live with your parents, and
they now get more than half of their support from your parents, and
they will continue to get this support between July 1, 2015-June 30, 2016 .
If more space is needed, attach a separate page with your name and student ID at the top.
Full Name
Age
Relationship
College/Post-Secondary School
Self
West Georgia Technical College
Section C: Other Information
1.
2.
Did anyone listed in Section B of this worksheet receive benefits from the Supplemental Nutrition Assistance Program or
SNAP/Food Stamps any time during the 2013 or 2014 □ yes □ no?
Did anyone listed in Section B pay child support in 2014? □ yes □ no If yes, please complete the chart below.
Name of Person Who Paid
Child Support
Name of Person Whom Child
Support was Paid
Name of Child Whom Support Was
Paid
Amount of Support Paid
in 2014
Section D: 2014 Income Information
Indicate whether a 2014 federal tax return or extension was(or will be) filed for each:
All Students:
For Dependent Students Only:
Student: □ yes □ filed extension □ no
Spouse: □ yes □ filed extension □ no □ N/A
Mother/Stepmother: □ yes □ filed extension □ N/A □ no
Father/Stepfather: □ yes □ filed extension □ N/A □ no
1.
2.
If “yes” was selected by any person above and that person did not use the IRS Data Retrieval Tool, their 2014 IRS Tax
Return Transcript must be submitted.
 To obtain an IRS Tax Return Transcript, go to www.IRS.gov and click on the “Order a Return Transcript” link or call 1800-908-9946. (We cannot accept a copy of tax returns)
If “no” was selected by any person above, attach all W-2 forms and complete the chart below.
Did not file, but earned income
Student
□ yes □ no
Spouse
□ yes □ no
Mother/Stepmother
□ yes □ no
Father/Stepfather
□ yes □ no
Source of Income/Employer
2014 Total Income Earned
$
$
$
$
Section E: Certification and Signature
Each person signing this form certifies that all the information on it is complete and correct.
Warning: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
If the student is Dependent, one parent whose information was reported on the FAFSA must sign and date.
Student’s Signature
Parent’s Printed Name
Date
Parent’s Signature (if dependent)
Date
As set forth in its student catalog, West Georgia Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age,
political affiliation or belief, genetic information, veteran status, or citizenship status (except in those special circumstances permitted or mandated by law). Equity (Title IX)
Coordinator, Dr. Tonya Whitlock, Vice President for Student Affairs, tonya.whitlock@westgatech.edu, 401 Adamson Square, Carrollton, GA 30117, 678.664.0532. ADA (Section 504)
Coordinator, Dr. Rick Leveille, Vice President for Administrative Services, rick.leveille@westgatech.edu, 401 Adamson Square, Carrollton, GA 30117, 678.664.0533.
Verification Form - Revised: 10/30/2015