Phone: 215.895.1600
Fax: 215.895.2939
Email via ask.drexel.edu
drexel.edu/drexelcentral
2016–2017 Supplemental Verification Worksheet
Please complete the sections below that pertain to you and/or your parent(s). Please make sure all appropriate individuals sign the bottom of the
second page.
Student’s Name ___________________________________________ University ID __________________________
Real Estate Information
Please fill in the information for all properties (other than family’s primary residence) that were reported on your and/or your parent(s)’ 2015 IRS
Schedule E.
Property Address
Current Value of Property
Current Mortgage on Property
Name of Property Owner
Business Value Information
Please fill in the information for all businesses that were reported on your and/or your parent(s)’ 2015 IRS Schedule C or E.
Business Name
Type of
Business
Number of FullTime Employees
Current Value of
Business
Current Debt
Associated with Business
Name of Business Owner
Farm Value Information
Please fill in the information below for all farms that were reported on your and/or your parent(s)’ 2015 IRS Schedule F.
Farm Name
Is this a Family Farm
that you live on and
operate?
Current Value of Farm Assets
(including the property of the
farm)
Current Debt
Associated with the
Farm
Name of Farm Owners
Child Support Received Information
Please fill in the information for all child support received in 2015 by either yourself or your parent(s). Please make a separate entry for
every child for whom support was received.
Name of Person Who Received
the Child Support
Name of Person Who Paid the
Child Support
Name of Child the Support Was
Paid For
Age of
Child
Amount of Child
Support Received in
2015
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Phone: 215.895.1600
Fax: 215.895.2939
Email via ask.drexel.edu
drexel.edu/drexelcentral
2016–2017 Supplemental Verification Worksheet (page 2)
Child Support Paid Information
Please fill in the information for all child support paid in 2015 by either you or your parent(s). Please make separate entries for every child for
whom support was paid.
Name of Person Who Paid the
Child Support
Name of Person Who Received
the Child Support
Name of Child the Support
Was Paid For
Age of
Child
Amount of Child Support
Paid in 2015
Student Income Explanation
Please fill in the amounts below to explain the low or no income the student reported on the 2016–2017 FAFSA (only for independent students).
Cost
Monthly Amount of Money Received for This Expense
Money Provided By
Rent/Mortgage
Utilities (including groceries)
Car Payment/Insurance
Other (credit cards, medical bills, etc.)
Parent Income Explanation
Please fill in the amounts below to explain the low or no income the parent reported on the 2016–2017 FAFSA (only for dependent students).
Cost
Monthly Amount of Money Received for This Expense
Money Provided By
Rent/Mortgage
Utilities (including groceries)
Car Payment/Insurance
Other (credit cards, medical bills, etc.)
Bank Account and Cash Information
Please fill in the information below regarding the student’s and parent(s)’ balances of bank accounts and cash amounts as of the date you signed
your 2016–2017 FAFSA.
Source
Student
Parent
Cash Available
Checking Account Balance
Savings Account Balance
Signatures
By signing this worksheet, I/we certify that all of the information reported to qualify for federal financial aid is complete and correct. I/we
understand that giving false or misleading information on this worksheet can result in a fine, jail sentence, or both.
Student Signature: ________________________________________________________________ Spouse Signature (if married): _______________________________________________________ Date: _______________
Date: _______________
Parent Signature: _________________________________________________________________ Date: _______________
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