College of DuPage        2016‐2017 V1 Worksheet Independent Office of Student Financial Assistance Last Name:   

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College

 

of

 

DuPage

 

`

Office

 

of

 

Student

 

Financial

 

Assistance

 

Last

 

Name:

   

      

2016

2017

 

V1

 

Worksheet

 

Independent

 

 

First

 

Name:

  

___________________________

 

 

 

 

 

 

 

Student

 

ID:

   

Your   2016 ‐ 2017   Free   Application   for   Federal   Student   Aid   (FAFSA)   was   selected   for   “

VERIFICATION

”   by   the   Federal  

Processor/Institution.

 

This   means   we   are   required   to   confirm   the   information   you   reported   on   your   FAFSA.

   If   there   is   conflicting   information,   we   may   make   a   correction   to   your   FAFSA   and/or   ask   for   additional   information.

  

Failure   to   submit   requested   documents   will   result   in   your   financial   aid   not   being   processed.

   If   you   have   questions   about   verification,   contact   the   College   of   DuPage   Office   of   Student   Financial   Assistance   as   soon   as   possible   so   that   your   financial   aid   will   not   be   delayed.

 

 

 

A.

  Household   Size

  –   In   the   box   below,   please   list   the   people   in   your   household   that   you   (and   if   married,   your   spouse)   financially   support   more   than   50%.

  The   following   people   should   be   included:  

 

Yourself  

 

Your   spouse,  

if   married   at   the   time   you   originally   submitted   your   FAFSA

 

You   or   your   spouse’s   children  

if   you   and/or   your   spouse   will   provide   more   than   50%   of   their   support   from   July   1,  

2016   through   June   30,   2017,   even   if   the   children   do   not   live   with   you   and/or   spouse.

  

Support   includes,   but   is   not   limited   to,   housing,   clothes,   medical,   dental,   transportation,   payment   of   college   costs,   etc.

 

Other   people   if

  they   now   live   with   you   and/or   your   spouse   and   you   and/or   your   spouse   provide   more   than   50%   of   their   support   and   will   continue   to   provide   more   than   50%   of   their   support   from   July   1,   2016   through   June  

30,   2017.

  

Support   includes,   but   is   not   limited   to,   housing,   clothes,   medical,   dental,   transportation,   payment   of   college   costs,   etc.

 

 

 

Include   the   name   of   the   college   for   any   household   member   who   will   be   enrolled  

at   least   half   time

  in   a   degree,   diploma,   or   certificate   program   at   an   eligible   postsecondary   educational   institution   any   time   between   July   1,   2016   and   June   30,  

2017.

  If   more   space   is   needed,   attach   a   separate   page   with   the   student’s   name   and   Student   ID   at   the   top.

 

Full   Name

 

Age

 

Relationship to   student

 

Name   of  

College  

Will   be   Enrolled   at

Least   Half   Time

 

 

Missy   Jones   (example)

  

 

18

   

Sister

   

College of DuPage

  

 

Yes

 

1.

2.

3.

4.

5.

6.

 

B.

  In   2014   or   2015

,  

did   you   or   anyone   in   your   household

 

(those   listed   in   Section   A   of   this   form)   receive   benefits   from   the     

     Supplement   Nutrition   Assistance   Program  

(

SNAP

)?

           

YES

                   

 

NO

 

 

 

 

C.

 

Student

 

Income

 

and

 

Tax

 

Information

 

–  

Answer   each   question   as   it   applies   to   you:  

1)   Did   you   work   in   2015?

  

Answer   yes,   even   if   you   were   paid   in   cash.

     

YES

 

2)   Did   you   file   a   2015   Federal   Tax   Return?

           

YES

   

 

NO

NO

 

 

2016 ‐ 2017   V1   Worksheet   Independent                                               1                                                                                    02/02/16  

Student’s Name: ID:

*   If   a   foreign   tax   return   was   filed,   please   provide   us   with   a   copy   of

 

the   translated   foreign   tax   return.

 

 

 

3)

 

IF

 

YOU

 

DID

 

NOT

 

FILE

 

A

 

2015

 

FEDERAL

 

TAX

 

RETURN

 

BUT

 

WORKED,

 

attach   copies   of   all   2015   IRS   W2   and/or   1099   

      forms.

 

 

  

EMPLOYER’S   NAME

 

2015 income W2/1099    Attached?

Suzy’s   Auto   Body   Shop   (example)

 

$2,000.00(example)

 

Yes(example)

1.

 

2.

 

3.

 

 

 

 

 

D.

 

Spouse

 

Income

 

and

 

Tax

 

Information

 

–  

Answer   each   question   as   it   applies   to   the   spouse   whose   information   you   listed   on   your   2016 ‐ 2017   FAFSA   and   is   included   in   Section   A:  

 

 

 

1)   Did   your   spouse   work   in   2015?

  

Answer   yes,   even   if   paid   in   cash.

 

3.

 

4.

 

5.

 

Suzy’s   Auto   Body   Shop  

(example)  

1.

 

2.

 

            

YES

 

$2,000.00

(example)  

 

 

 

 

 

 

NO

 

 

 

2)   Did   your   spouse   file   a   2015   Federal   Tax   Return?

                                YES  

 

NO  

 

*   If   a   foreign   tax   return   was   filed,   please   provide   us   with   a   copy   of

 

 

the   translated   foreign   tax   return.

   

 

 

 

3)

 

IF

 

YOUR

 

SPOUSE

 

DID

 

NOT

 

FILE

 

A

 

2015

 

FEDERAL

 

TAX

 

RETURN

 

BUT

 

WORKED,

 

attach   copies   of   all   2015   IRS   W2   

      and/or   1099   forms.

 

EMPLOYER’S   NAME  

     

2015 income  

W2/1099    Attached?

Yes  

(example)

 

 

 

 

 

CERTIFICATION:  

I/WE   certify   that   all   information   on   this   form   is   true,   complete   and   accurate.

  Upon   request   I   agree   to   provide   additional   proof   of   the   information   reported   on   this   form.

  

Warning:

  If   you   purposely   give   false   or   misleading   information,   you   may   be   fined   up   to   $20,000,   sent   to   prison,   or   both.

 

 

 

Student   Signature                   Date  

Please

 

return

 

this

 

form

 

to:

                             

College   of   DuPage,   Office   of   Student   Financial   Assistance   –   SSC   2220  

425   Fawell   Blvd.,   Glen   Ellyn,   IL   60137   FAX   (630)   942 ‐ 2151   EMAIL:   [email protected]

 

The   college   will   not   discriminate   in   its   programs   and   activities   on   the   basis   of   race,   color,   religion,   creed,   national   origin,   sex,   age,   ancestry,   marital   status,   sexual   orientation,   arrest   record,   military   status   or   unfavorable   military   discharge,   citizenship   status,   physical   or   mental   handicap   or   disability   (Board   Policy   5010;   20 ‐ 5).

 

2016 ‐ 2017   V1   Worksheet   Independent   2

02/02/16  

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