ICSP16
CAMERON UNIVERSITY
INDEPENDENT STUDENT CHILD SUPPORT PAID
Academic Year 2015-2016
Your 2015–2016 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. To verify that you provided correct information, we will compare your FAFSA with the information on this
worksheet and with any other required documents. 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 to our
office. If the answer is zero, write “0”; do not leave blank.
A. Independent Student’s Information
_____________________________________________________________
Student’s Last Name
Student’s First Name
Student’s M.I.
____________________________________
Student’s ID Number
_____________________________________________________________
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 Number
B. Child Support Paid
Did you or your spouse pay child support in 2014?
If yes, please provide the following information:
Yes
No
Complete this section if you or your spouse, if married, paid child support in 2014.
Name of Person Who Paid Child
Name of Person to Whom Child
Name and Age of Child for
Support
Support was Paid
Whom Support Was Paid
Marty Jones(example)
Chris Smith
Terry Jones Age 10
Amount of Child
Support Paid in 2014
$6,000.00
NOTE: If we have reason to believe that the information regarding child support paid is not accurate, we may require additional
documentation, such as:



A copy of the separation agreement or divorce decree that shows the amount of child support to be provided;
A statement from the individual receiving the child support certifying the amount of child support received; or
Copies of the child support payment checks or money order receipts.
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ICSP16
Student ID:
C. Certification and Signatures
Each person signing this form certifies that all the
information reported on it is complete and correct. The
student must sign and date. The spouse’s signature is
optional.
WARNING:
If you purposely give false or
misleading information on this worksheet, you may
be fined, be sentenced to jail, or both.
Student’s Signature (required)
Date
Spouse’s Signature (optional)
Date
Submit this worksheet and required documents to:
Office of Financial Assistance
Cameron University – North Shepler #301
2800 West Gore Boulevard
Lawton, OK 73505-6320
FAX: 580-581-2556, Email: financialaid@cameron.edu
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