2015-16 Verification Worksheet V1 For Federal Student Aid Programs
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1
2North Arkansas College
Student ID#_______________
2015-16 Verification Worksheet V1 for Federal Student Aid Programs
Financial Aid Office * 1515 Pioneer Drive * Harrison, AR 72601 * 870-391-3266 * 870-391-3340 (fax)
Your application was selected for review in a process called “verification”. If there are differences between the data on your FAFSA and the
verification documents you submit to our office, we will make corrections and send them for reprocessing by the federal processor. We
may ask for additional information at a later date.
A.
Student Information
Last Name
First Name
M.I.
Social Security Number
Date of Birth
Street Address (include apt. #)
City
State
Zip Code
Phone Number (include area code)
B.
Family Information
___ DEPENDENT STUDENT:
___ INDEPENDENT STUDENT:
List the people in your parent(s)’ household
List the people in your household.
Yourself and your parent(s) (including step-parent) even if
Yourself your spouse, if married.
you don’t live with your parent(s).
Your children, if any, if you will provide more than 1/2 their
Your parent(s)’ other children if your parent(s) will provide
support from 7-1-2015 thru 6-30-2016.
more than 1/2 their support from 7-1-2015 thru 6-30-2016.
Other people if they now live with you and you provide
Other people if they now live with your parent(s) and your
more than 1/2 their support and will continue to provide
parent(s) provide more than 1/2 their support and will
more than 1/2 their support thru 6-30-16.
continue to provide more than 1/2 their support thru 6-30-16
Full Name
Age
Relationship
College
Will be Enrolled
(if not attending a college,
at Least Half
leave this column blank)
Time
SELF
North Arkansas College
C.
Income Information to Be Verified
1. TAX RETURN FILERS—
Complete this section if you, your parent (if dependent), or your spouse (if married) has filed
or will file a 2014 income tax return with the IRS. Check the box that applies:
STUDENT
Parent / Spouse
I used the IRS Data Retrieval Tool in FAFSA on the Web to automatically retrieve & transfer my
2014 IRS income information into my FAFSA, and did not change any of the information once it
was retrieved. (The IRS information will be used in the verification process.)
I am unable, or choose not, to use the IRS Data Retrieval Tool in FAFSA on the Web. I will submit
to the school 2014 IRS tax return transcript(s). PHOTOCOPIES OF TAX RETURNS WILL NOT
BE ACCEPTED!! (Go to or call 1-800-908-9946 to order a Tax Return Transcript
from the IRS. Do not order an Account Transcript.)
I have filed, or will file an amended 2014 IRS tax return. I will submit to the school 2014 IRS tax
return transcript(s). PHOTOCOPIES OF TAX RETURNS WILL NOT BE ACCEPTED!!
Revised 1-16-15
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