College of DuPage
Office of Student Financial Assistance
2015-2016 Verification of Household Size Dependent
Last Name:
First Name:
Student ID:
Your 2015-2016 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.
NOTE: Please answer each question as it applies to the student and parent(s) whose information is on the FAFSA.
A. Household Size – In the box below, please list the people in your parent(s) household that your parent(s) financially support
more than 50%. The following people should be included:
 Yourself
 Your parent(s), including a step-parent, as reported on the FAFSA.
 Your parent’s other children if your parent(s) will provide more than 50% of their support from July 1, 2015 through June
30, 2016, or if the other children would be required to provide parental information if they were completing a FAFSA for
2015-2016. Include children who meet either of these standards, even if the children do not live with your parent(s).
Support includes, but is not limited to, housing, clothes, medical, dental, transportation, payment of college costs, etc.
 Other people if they now live with your parent(s) and your parent(s) provide more than 50% of their support and will
continue to provide more than 50% of their support from July 1, 2015 through June 30, 2016. Support includes, but
is not limited to, housing, clothes, medical, dental, transportation, payment of college costs, etc.
Also include the name of the college for any household member, excluding your parent(s,) 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, 2015
and June 30, 2016. If more space is needed, attach a separate page with the student’s name and Student ID at the top.
Full Name
Missy Jones (example)
Age
Relationship
to student
18
Sister
Name of
College
College of DuPage
Will be Enrolled at
Least Half Time
Yes
1.
2.
3.
4.
5.
B. In 2013 or 2014, did you or anyone in your parent(s) household (those listed in Section A of this form) receive benefits
from the Supplement Nutrition Assistance Program (SNAP)?
YES
NO
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
Parent 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: financialaid@cod.edu
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).
2015-2016 Verification of Household Size Dependent
1
02/25/16