2023-2024 Independent Verification

If you need assistance with this form, contact Mid Michigan College Financial Aid at Phone (989) 386-6664 or finaid@midmich.edu.

Student Name *

First NameLast Name

Mid Michigan College Student ID Number*

You can find your Student ID Number on your Mid Michigan College Student ID Card or in myMid.

Enter Your Mid Mich Email*

You MUST provide a Mid Mich Email so that we can verify your identity. Other emails will not be accepted and you will be unable to complete this form.

ERROR The email you entered is not a Mid Mich Email. In order to complete this form, you must enter a Mid Mich Email so we can verify your identity.

Re-enter your Mid Mich Email for verification, Click 'Verify Email', and follow the directions. *

Are you currently married?

YesNo

Independent Students

List the people in your parent’s household, including

You and your spouse (if married), unless your spouse is not living in the household due to separation or divorce
Your children if you provide more than half of their support from July 1, 2023 through June 30, 2024, even if they do not live with you
Other people if they now live with you and your spouse (if married) and provide more than half of their financial support and will continue to provide more than half of their support from July 1, 2023 through June 30, 2024.

Write in the full name of the college for any household member who will be attending a postsecondary education institution at least half-time from July 1, 2023 through June 30, 2024, and will be enrolled in a degree, diploma, or certificate program.

Details about yourself and other household members as defined above.

	Full Name	Age (as of 1/1/23)	College (do not abbreviate)
1- Self
2 - Spouse
3 - Other
4 - Other

I need additional rows for household members.*

YesNo

Other household members as defined above, continued.

	Full Name	Age (As of 1/1/23)	Relationship to Student (ie Parent, Sibling, Other)	College (do not abbreviate)
6
7
8
9
10
11
12
13
14
15

STUDENT You must check one of the following*

I have filed a 2021 Federal income tax return and will provide a Tax Return Transcript or utilize the IRS Data Retrieval Tool within FAFSA.I did not file, will not file, and am not required to file a 2021 Federal income tax return as I had NO income earned from work. I will provide an IRS Verification Non Filing Letter.I did not file, will not file, and am not required to file a 2021 Federal income tax return but I DID have income earned from work. I will submit copies of all 2021 W2(s) and provide an IRS Verification Non Filing Letter.

List employer(s) below and any income received in 2021, even if you did not receive a W2.*

	Employer Name	Amount Earned in 2021
Employer 1
Employer 2
Employer 3

SPOUSE You must check one of the following*

I have filed a 2021 Federal income tax return and will provide a Tax Return Transcript or utilize the IRS Data Retrieval Tool within FAFSA.I did not file, will not file, and am not required to file a 2021 Federal income tax return as I had NO income earned from work. I will provide an IRS Verification of Non Filing Letter.I did not file, will not file, and am not required to file a 2021 Federal income tax return but I DID have income earned from work. I will submit copies of all 2021 W2(s) and provide an IRS Verification Non Filing Letter.

List employer(s) below and any income received in 2021, even if you did not receive a W2.*

	Employer Name	Amount Earned in 2021
Employer 1
Employer 2
Employer 3

Certifications and Signatures

The College must review the requested information, under the financial aid program rules (CFR title 34, Part 668). If you are the student, by signing this application you certify that you (1) will use federal and/or state student financial aid only to pay the cost of attending an institution of higher education, (2) are not in default on a federal student loan or have made satisfactory arrangements to repay it, (3) do not owe money back on a federal student grant or have made satisfactory arrangements to repay it, (4) will notify your school if you default on a federal student loan and (5) will not receive a Federal Pell Grant for more than one school for the same period of time. If you are the parent or the student, by signing this application you agree, if asked, to provide information that will verify the accuracy of your completed form. This information may include your U.S. or state income tax forms that you filed or are required to file. Also, you certify that you understand that the Secretary of Education has the authority to verify the information reported on this application with the Internal Revenue Service and other federal agencies. If you sign any document related to the federal student aid programs electronically using a Personal Identification Number(PIN), you certify that you are the person identified by the PIN and have not disclosed that PIN to anyone else.

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

Student Signature*

Date*

MonthDayYear

Spouse's Signature*

Date*

MonthDayYear

Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier you can report the barrier at midmich.edu/reportaccessibilitybarrier or contact Financial Aid at (989) 386-6664 or finaid@midmich.edu.

In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.

2023-2024 Independent Verification

Student Email Verification

Student Status

Tax Information

Certifications and Signatures