It takes a minimum of 5 to 10 days for all Verification forms and documentations to be reviewed. A. Student's InformationStudent Name(Required) First Middle Initial Last BSC ID Number(Required) Address(Required) Street Address Apt. No. City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone(Required)Phone Type(Required)HomeOfficeCellB. Student’s Family InformationIt takes a minimum of 5 to 10 days for all Verification forms and documentation to be reviewed. 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 2023-2024 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, 2024. (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, 2023 and June 30, 2024, 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.List PeopleFirst and Last NameAgeRelationship to StudentName of College, if any each person will attend in 2023-2024 at least half-time Add RemoveC. Student’s Tax Forms and Income InformationINSTRUCTIONS: The best way to verify student and parent(s) 2021 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 2021 IRS Income Tax information into the student’s FAFSA.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.1. Check the item below that applies:(Required) I used the IRS Data Retrieval Tool in FAFSA on the Web to retrieve and transfer 2021 IRS income information into the FAFSA (must submit 2021 W-2 Form(s) and Schedules) I did not use the IRS Data Retrieval Tool, must submit a signed copy of my 2021 IRS Tax Return and copy of all 2021 W-2 forms and Schedules I was employed in 2021 but will not file a Federal Tax Return because I am not required to file. Submit copies of all 2021 W-2s, 1099’s forms. I was not employed and had no income earned from work in 2021. 2. If your employer did not supply a 2021 W-2, request a 2021 Wage Statement from the IRSD. Parent’s Tax Forms and Income InformationNote: If two parents were reported in Section B of this worksheet, the instructions and certifications below refer and apply to both parents.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.1. Check the item below that applies: I used the IRS Data Retrieval Tool to transfer 2021 IRS income information into the FAFSA. If an amended 2021 IRS tax return has been or will be filed, a signed copy of the 2021 IRS Tax Return and a signed copy of the 2021 IRS 1040X Amended US Individual Income Tax Return must be submitted. The IRS Data Retrieval Tool cannot be used. Submit copies of all 2021 W-2’s and Schedules I did not use the IRS Data Retrieval Tool, must submit a signed copy of the 2021 IRS Tax Return and all 2021 W-2’s and Schedules. If Married Filing Separate- Must provide a signed copy of the 2021 IRS Tax Return for both parents. I was employed in 2021 but will not file a 2021 Federal Tax Return because I am not required to file. Must submit a 2021 IRS Non-Filing Statement for both parents. Submit copies of all 2021 W-2s, 1099 forms and other earnings statement. I was not employed and had no income earned from work in 2021. Must submit a 2021 IRS Non-Filing Statement. 2. If your employer did not supply a W-2 or other earnings statement, request a 2021 Wage Statement from the IRS. VerificationVerification cannot be completed until all signed 2021 IRS Tax Return and W-2’s has been submitted to the school.Certification and SignatureEach person signing this worksheet certifies that all of the information reported on it is complete and correct. The student and one parent must sign.Student's Signature(Required)Parent's Signature(Required) TweetShareShare