2023-2024 Verification Worksheet

Name*

First NameMiddle NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Enter the names of all household members in the space(s) below. Also write in the name of the college for any household members, excluding the parent(s), who will be enrolled at least half time, in a degree, diploma, or certificate program between July 1, 2023, and June 30, 2024.

	Full Name	Age	Relationship	College	Will Be Enrolled At Least Half Time?
Household Member 1
Household Member 2
Household Member 3
Household Member 4
Household Member 5
Household Member 6
Household Member 7
Household Member 8

Check all that apply

Check here if you have used the IRS Data Retrieval Tool to retrieve and transfer 2021 IRS income information into the FAFSACheck here if a 2021 IRS tax return transcript/tax return is attached to this worksheet (upload document(s))Check here if you will not file and are not required to file a 2021 US income tax return

2021 IRS Tax Return Transcript/Tax Return (Student)

Sources of Untaxed Income

	2021 Amount ($)
Child Support Received
Social Security Benefits
Disability Benefits
Other

If you did not file and are not required to file a 2021 Federal income tax return, list below the source and the amount of any income earned in 2021. If the income was earned from work, please list your employer and provide a copy of your 2021 W2.

	Employer Name	2021 Amount Earned ($)	Attach IRS W2?
Employer 1
Employer 2
Employer 3

IRS W2 (Student)

Check all that apply

Check here if you have used the IRS Data Retrieval Tool to retrieve and transfer 2021 IRS income information into the FAFSACheck here if a 2021 IRS tax return transcript/tax return is attached to this worksheet (upload document(s))Check here if you will not file and are not required to file a 2021 US income tax return

2021 IRS Tax Return Transcript/Tax Return (Parent(s))

Sources of Untaxed Income

	2021 Amount ($)
Child Support Received
Social Security Benefits
Disability Benefits
Other

If you did not file and are not required to file a 2021 Federal income tax return, list below the source and the amount of any income earned in 2021. If the income was earned from work, please list your employer and provide a copy of your 2021 W2.

	Employer Name	2021 Amount Earned ($)	Attach IRS W2?
Employer 1
Employer 2
Employer 3

IRS W2 (Parent(s))

Check all that apply

STUDENT: Check this box if you did not have any income in 2021 and did not file 2021 taxesPARENT(S): Check this box if you did not have any income in 2021 and did not file 2021 taxes

Non-dependent students must submit an IRS "Verification of Nonfiling (VNF) Letter" or other IRS documentation that clearly states the IRS does not have a tax record for 2021. If you are a non-dependent student, please upload an IRS VNF Letter or other IRS documentation clearly stating that the IRS does not have a tax record for 2021.

Provide an explanation of means of support:

Each person signing this form certifies that all the information reported on it is complete and correct. If Dependent, the student and one parent must sign and date.

WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.

Student Signature*

Date*

Date

Parent Signature

Date

2023-2024 Verification Worksheet

A. Student Information

B. Family Information

C. Student's Tax & Income Information

D. Parent(s) Tax & Income Information

E. Non-Filer Status with Zero Income

F. Certification and Signature