2018-2019 Dependent Verification Worksheet

1 KENT STATE. UNIVERSITY 2018 - 2019 Dependent Student Verification Worksheet Student Name:_____ Kent State ID Number: _____Permanent Address: _____ Phone Number: _____ Preferred Email: _____ Submit all requested information to the Kent State University One Stop for Student Services using one of the following options: Mail: One Stop for Student Services, Kent State University, Box 5190, Kent, Ohio 44242-0001 Fax: 330-672-6001 Contact Us: In Person: One Stop for Student Services, 1st floor, University Library (Kent Campus)SECTION 1: HOUSEHOLD INFORMATION Dependent STUDENT: List the people in your parent(s) household.

2 Include yourself (the student); the parents/stepparent on your FAFSA form; their children if they will provide more than half of their support through June 30, 2019 ; and any other people that live with them, if they will provide more than half of their support through June 30, 2019 . Include everyone in the household. First and Last Name of Household Member Date of Birth Relationship to Student Will this person live in your parent s household through June 30, 2019 ? Will your parents support this person at least 51% through June 30, 2019 ? Name of college they will attend at least half time during 2018 - 2019 (if applicable) Student FAFSA Parent 1 FAFSA Parent/Stepparent 2 Yes No Yes No Yes No Yes No Yes No Yes No Yes NoAttach additional sheet of paper if necessary Definition of Parent: A parent is defined as the biological or adoptive parent(s) of the student.

3 If parents are married to each other, both parents information must be included. If parents are not married to each other but still live together in the same household, both parents information must be included. If the student s parents are divorced or separated, use the information for the parent the student lived with more during the past 12 months. If that parent is remarried, the data must also include the stepparent s information. A legal guardian, grandparent, or foster parent is not considered a parent unless they have legally adopted the student. SECTION 2: TAX FILING STATUS AND REQUIRED DOCUMENTATION Select the student federal tax filing status: (All students must complete this section) Select ONE.

4 I did not work in 2016. I did not and will not file a 2016 federal tax return. The student must sign this statement: I, _____, certify that I did not and will not file a 2016 federal tax return. (Student signature) I completed a 2016 federal tax return. Select one option below: I used the IRS Data Retrieval Tool on the FAFSA. Date used: _____ I will submit a copy of my 2016 Federal IRS Tax Return Transcript I worked in 2016, but I did not file a 2016 federal tax return. The student must sign this statement: I, _____, certify that I did not and will not file a 2016 federal tax return. (Student signature) You must submit the following: 1. Copies of 2016 W-2 forms from all employers 2. List below all your employers and the amount you earned from each in 2016 Employer s Name 2016 Earnings Attach additional sheet of paper if necessary Select the parent/stepparent(s) federal tax filing status: (if parent information was provided on the FAFSA) Select ONE.

5 The parents/stepparent on my FAFSA completed a 2016 federal income tax return. Select one option below: They used the IRS Data Retrieval Tool on the FAFSA. Date used: _____ They will submit copies of their 2016 Federal IRS Tax Return Transcript(s) The parents/stepparent on the FAFSA worked in 2016, but were not required to file a 2016 federal tax return. You must submit the following: 1. IRS Non-Filing Letter for each parent/stepparent on the FAFSA 2. Copies of 2016 W-2 forms from all employers for each parent/stepparent on the FAFSA 3. List below all employers and the amount each parent/stepparent earned in 2016 Employer Name Parent Name 2016 Earnings Attach additional sheet of paper if necessary _____ _____ _____ _____ No parents/stepparent on the FASFA worked in 2016.

6 They did not and will not file a 2016 federal tax return. You must submit the following: 1. IRS Non-Filing Letter for each parent/stepparent on the FAFSA 2. Written explanation, signed by a parent, of how they financially met their basic living expenses in 2016 SECTION 3: UNTAXED INCOME INFORMATION Student Untaxed Income Information for Calendar Year 2016 Found On 2016 Federal Income Tax Return Parent(s) or Stepparent $_____ Rollover Untaxed portions of IRA Distributions reported on 2016 Federal Income Tax Return (Line 15a minus 15b on 1040, or Line 11a minus 11b on 1040a). Check the box if this was a rollover. $_____ Rollover $_____ Rollover Untaxed portions of Pension & Annuities reported on 2016 Federal Income Tax Return (Line 16a minus 16b on 1040, or Line 12a minus 12b on 1040a). Check the box if this was a rollover.

7 $_____ Rollover SECTION 4: SIGNATURES This form must be signed by the student and at least one parent. By signing this application, you hereby affirm that all information reported on this form and any attachment hereto is true, complete, and accurate to the best of your knowledge. If asked by an authorized official, you agree to provide additional proof of information provided on this form. You understand that the Student Financial Aid Office at Kent State University will correct the FAFSA application, as necessary, based on the information submitted. You agree that you understand that if you received federal student aid based on incorrect information, you will need to repay it. You may also be required to pay fines and fees. By signing below, 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 college if you default on a federal student loan and (5) will not receive a Federal Pell Grant from more than one college for the same period of time.

8 Student Signature Date Parent/Stepparent Signature Date SECTION 5: CHECK LIST Complete and sign Verification Worksheet Use the IRS Data Retrieval Tool on the FAFSA or obtain all 2016 Federal IRS Tax Return Transcripts Obtain IRS Non-Filing Letters, if applicable Provide copies of 2016 W-2 forms, if required. W-2 forms may be requested separate from this Worksheet . Check your FlashLine account for outstanding requirements Provide list of employers on Verification Worksheet and the total amount earned from each during 2016, if required Provide a signed statement of how the family met basic living expenses during 2016, if required SECTION 6.

9 IMPORTANT DOCUMENTATION INFORMATION IRS Tax Return Transcript If you did not originally use the IRS Data Retrieval Tool when you filed the FAFSA, you may submit a correction at and use the tool instead of submitting an IRS Federal Tax Return Transcript. Some tax filers may not be able to use the IRS Data Retrieval Tool. If that applies to you, submit the IRS Tax Return Transcript. A Federal IRS Tax Return Transcript can be obtained online or by mail, free of charge, by visiting (click on Get My Tax Record ) or by calling 1-800-908-9946. Be sure to request a Return Transcript and not an Account Transcript. Federal financial aid policies do not allow us to accept a copy of your federal tax return or state tax return. If you filed an amended tax return for 2016, you must provide a copy of your tax transcript (which will include only information from the original tax return) and a signed copy of the 2016 IRS form 1040X that was filed with the IRS.

10 If you or your parent/stepparent has a 2016 tax extension beyond the automatic six-month extension, you must submit IRS form 4868 for tax year 2016, a copy of the IRS s approval of an extension beyond six months, and a copy of all 2016 W-2 s. Additionally, you must submit an IRS Non-Filing Letter dated after October 1, 2017. If you were a victim of IRS tax-related identity theft and cannot obtain an IRS Tax Return Transcript, you can instead provide a Tax Return DataBase View (TRDBV) Transcript and a statement signed and dated by the tax filer indicating that he or she was a victim of IRS tax-related identity theft and that the IRS is aware of the tax-related identity theft. You must contact the IRS at 1-800-904-4490 to request a TRDBV Transcript. If you filed a foreign 2016 tax return or a tax return with Guam, the Northern Mariana Islands, Puerto Rico, or the Virgin Islands, please contact the One Stop for Student Services for further instructions.