2022-2023 Verification Worksheet Dependent Students

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Dependent Verification Worksheet

It takes a minimum of 5 to 10 days for all Verification forms and documentations to be reviewed.

A. Student’s Information

Student’s Last Name	Student’s First Name	Student’s Middle Initial
Student’s Last Name	Student’s First Name	Student’s Middle Initial

BSC ID Number

Student’s Street Address (include apt. no.)

City/Town

State/Province

ZIP/Postal Code

Student’s Date of Birth

Student’s Phone Number or Cell Number

It takes a minimum of 5 to 10 days for all Verification forms and documentation to be reviewed.

B. Student’s Family Information

List ALL the people in your parent(s)’ household include:

Yourself and your parent(s) (including a stepparent) even if you don’t live with your parent(s).
Your parent(s)’ other children, even if they don’t live with your parent(s) if the children will be required to provide parental information on the 2022-2023 FAFSA and
Other legal court appointed dependents ONLY if they now live with your parent(s) and your parent(s) provide more than half of their support and will continue to provide more than half of their support through June 30, 2022. (must provide documentation)

Must list the name, age and relationship of all household members below. Also, indicate in the College Column which family member will attend college at least half, between July 1, 2022 and June 30, 2023, and will be enrolled in a degree, diploma, or certificate program. (do not list parents in college). If you need additional space, click the add button or plus sign.

Student’s Family Information
Full Name (first and last name) Age for all listed Relationship to Student Name of College, if any each person will attend in 2022-2023 at least half-time

more items

C. Student’s Tax Forms and Income Information

INSTRUCTIONS: The best way to verify student and parent(s) 2020 income is by using the IRS Data Retrieval Tool that is part of FAFSA on the Web. If the student or parent has not already used the tool, go to FAFSA.gov, log in to the student’s FAFSA record, select “Make FAFSA Corrections,” and navigate to the Financial Information section of the form. From there, follow the instructions to determine if you are eligible to use the IRS Data Retrieval Tool to transfer 2020 IRS Income Tax information into the student’s FAFSA.

1. Check the item below that applies:

Attention !! Please send any additional required documents to The Financial Aid Office by separate e-mail (financialaid@bluefieldstate.edu) or regular mail. Be sure to include the student id number on all documents that you forward to us.

I used the IRS Data Retrieval Tool in FAFSA on the Web to retrieve and transfer 2020 IRS income information into the FAFSA (must submit 2020 W-2 Form(s) and Schedules)

I did not use the IRS Data Retrieval Tool, must submit a signed copy of my 2020 IRS Tax Return and copy of all 2020 W-2 forms and Schedules

I was employed in 2020 but will not file a Federal Tax Return because I am not required to file. Submit copies of all 2020 W-2s, 1099’s forms.

I was not employed and had no income earned from work in 2020.

2. If your employer did not supply a 2020 W-2, request a 2020 Wage Statement from the IRS

D. Parent’s Tax Forms and Income Information

Note: If two parents were reported in Section B of this worksheet, the instructions and certifications below refer and apply to both parents.

1. Check the item below that applies:

Attention !! Please send any additional required documents to The Financial Aid Office by separate e-mail (financialaid@bluefieldstate.edu) or regular mail. Be sure to include the student id number on all documents that you forward to us.

I used the IRS Data Retrieval Tool to transfer 2020 IRS income information into the FAFSA. If an amended 2020 IRS tax return has been or will be filed, a signed copy of the 2020 IRS Tax Return and a signed copy of the 2020 IRS 1040X Amended US Individual Income Tax Return must be submitted. The IRS Data Retrieval Tool cannot be used. Submit copies of all 2020 W-2’s and Schedules

I did not use the IRS Data Retrieval Tool, must submit a signed copy of the 2020 IRS Tax Return and all 2020 W-2’s and Schedules. If Married Filing Separate- Must provide a signed copy of the 2020 IRS Tax Return for both parents.

I was employed in 2020 but will not file a 2020 Federal Tax Return because I am not required to file. Must submit a 2020 IRS Non-Filing Statement for both parents. Submit copies of all 2020 W-2s, 1099 forms and other earnings statement.

I was not employed and had no income earned from work in 2020. Must submit a 2020 IRS Non-Filing Statement.

2. If your employer did not supply a W-2 or other earnings statement, request a 2020 Wage Statement from the IRS.

Verification cannot be completed until all signed 2020 IRS Tax Return and W-2’s has been submitted to the school.

Certification and Signature

Each person signing this worksheet certifies that all of the information reported on it is complete and correct.
The student and one parent must sign and date.

Student’s Signature

Sign below

Student’s Date

Parent’s Signature

Sign below

Parent’s Date

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