Chowan University Financial Aid Office One University Place Murfreesboro, NC 27855 Phone: 252-398-6535 Fax: 252-398-6513 Email: finaid@chowan.edu Financial Aid Office Priority Dates Returning Students February 28, 2018 New Students April 30, 2018 A. STUDENT S INFORMATION 2018-2019 V5 Verification Packet Your 2018-2019 Free Application for Federal Student Aid (FAFSA) has been received and was selected for review in a process called verification. The law states that before awarding Federal Student Aid, we must confirm the information you reported on your FAFSA. To verify correct information was reported, we will compare your FAFSA with the information in this packet and with any other required documents. If there are differences, we will update your FAFSA. We may ask for additional information. If you have questions about verification, contact us as soon as possible so that your financial aid will not be delayed. Student s Name Date of Birth SSN XXX-XX- Permanent Mailing Address City, State Zip Code Student s Cell Phone Parent s Cell Phone Home Phone B. HOUSEHOLD INFORMATION & FORMS List people in your household from July 1, 2018 through June 30, 2019 DEPENDENT STUDENTS List the people in your parent s household, include: a. Yourself and your parents; include step-parents and biological parents who are not married but reside together. b. Siblings that live in the home (including those in college who your parent(s) provide at least 51% of their support). c. Any other people who live with your parent(s) if your parent(s) provide at least 51% of their support. Student Documents to Gather & Return a. Your 2016 Federal Tax Transcripts & Schedules b. Your 2016 W-2 s c. Verification of Non-Tax Filing Letter - If you did not work or file taxes. Request from IRS using form 4506-T Student - Parent Documents to Gather & Return a. Parent(s) 2016 Federal Tax Transcripts & Schedules b. Parent(s) 2016 W-2 s c. Verification of Non Tax Filing Letter Request from IRS using form 4506-T for any parent that did not work or file 2016 a tax INDEPENDENT STUDENTS List the people in your household, include: a. Yourself and your spouse (if married). b. Your children, if you provide more than half of their support (include those in college who you support). c. Any other people who you provide at least 51% of their support. Student Documents to Gather & Return a. Your 2016 Federal Tax Transcripts & Schedules b. Your 2016 W-2 s c. Verification of Non-Tax Filing Letter - If you did not work or file taxes. Request from IRS using form 4506-T Spouse Documents to Gather & Return a. Spouse 2016 Federal Tax Transcripts & Schedules b. Spouse 2016 W-2 s c. Verification of Non Tax Filing Letter Request from IRS using form 4506-T for a spouse that did not work or file a 2016 tax Full Name Age Relationship College/University Self Chowan University Enrolled at least Half Time(yes/no) V5 1
STUDENT NAME: CHOWAN ID #: Student Information Section C. STUDENT - Marital Status and/or Tax Filing Status - All Students please complete this section. What is your marital status as of today? Never Married (Only select this option if you have NEVER been legally married) Divorced or Separated Married or Remarried Widowed For 2016, have you (the student) completed your IRS income tax? (Please check one box) What income tax did you file or will you file for 2016? For 2016, what is or will be your tax filing status according to your tax? No, because I did not work No, because I worked, but was not required to file a Yes, I have already completed my I will file but have not yet completed my IRS 1040 IRS 1040A or 1040 EZ A foreign tax I do not know my filing status Single Head of household Qualifying widower Married filed joint Married filed a separate D. HOUSEHOLD BENEFITS Must be completed by all students. Please check if any of the benefits listed below were received in 2016 or 2017. Medicaid or Supplemental Security Income (SSI) Yes No Food Stamps (SNAP) Yes No Free/Reduced School Lunch Yes No Temporary Assistance for Needy Families (TANF) Yes No Women, Infants and Children (WIC) Yes No E. STUDENT ASSET INFORMATION As of Today Before we can process your verification, you MUST complete the asset section below. Write 0 for zero amounts. As of the Date you complete this form Amount in cash, savings and checking Net Real Estate (do not include your home) Net Investments (stocks, bonds, CDs, etc.) Net Business Worth and or investment farms (Don t include a family farm or family business with 100 or fewer full time employees) Student Spouse (If applicable) Please to: V5 2
STUDENT NAME: CHOWAN ID #: Parent Information Section F. PARENT - Marital Status and/or Tax Filing Status Who is considered a Parent according to the FAFSA - Parent Mother Father Stepparent Not a Parent Grandparents, Foster Parents Legal Guardians Widowed Stepparents Aunts, Uncles, & Siblings If the person(s) that is providing 51% or more of your support is NOT a Father/Mother/Stepparent, please STOP completing this form and contact the Financial Aid Office at 252-398-6535 for further assistance. As of today, what is the marital status of your legal parents? Never Married (Only select this option if you have NEVER been legally married) Divorced or Separated Married or Remarried Widowed For 2016, have you - the parent(s) - completed your IRS income tax? (Please check one box) What income tax did you file or will you file for 2016? For 2016, what is or will be your tax filing status according to your tax? No, because I/we did not work No, because I/we worked, but were not required to file a IRS 1040 I/we do not know my filing status Single Yes, I/we have already completed a IRS 1040A or 1040 EZ Head of household Qualifying widower I/we will file but have not yet completed a A foreign tax Married filed joint Married filed a separate G. ASSET INFORMATION As of Today Before we can process your verification, you MUST complete the asset section below. Write 0 for zero amounts. As of the Date you complete this form Amount in cash, savings and checking Net Real Estate (do not include your home) Net Investments (stocks, bonds, CDs, etc.) Net Business Worth and or investment farms (Don t include a family farm or family business with 100 or fewer full time employees) Parent Please to: V5 3
STUDENT NAME: CHOWAN ID #: Untaxed Income Section ALL Students/Parents Complete DO NOT LEAVE BLANK H. UNTAXED INCOME Calendar Year 2016 If you indicated in Section C or F that the student, spouse, or either parent DID NOT file a 2016 Federal Tax Return, this individual must submit Verification of Non Filing Letter from the IRS. Use Form 4506-T from the IRS if applicable. Please provide information about any other resources, benefits, or funds received by the student or members of the student s household. For Non-Tax Filers some form of assistance is required to be reported in this section. This may include items that WERE NOT required to be reported on the FAFSA. Person/Organization Providing Support Write 0 for zero amounts if not applicable. Alimony Received Child Support Received Clergy (housing, clothing, food or cash) Unemployment Compensation Disability from Social Security Administration (include amounts for dependents) Please refer to your copy of SSA-1099 Disability (Private Company) Supplemental Security Income (SSI) Please refer to your end of the year statement Non-educational VA Benefits Self-Employment (Not reported on taxes) Financial Assistance from family members Source: ex. Grandmother Jane Doe paid for cell phone Source: Source: Received by Student ex. $70/month List Monthly Amount Received by Parent(s)/Spouse I. Certification and Signatures If you are the parent or the student, by signing below you certify that all of the information you provided is true and complete to the best of your knowledge and you agree, if asked, to provide information that will verify the accuracy of your completed form. By signing below, I/we authorize the Financial Aid Office to perform necessary electronic corrections to the FAFSA on my behalf. I/we realize that any false statement or failure to give proof when asked may be cause for denial, reduction, withdrawal, and/or repayment of my financial aid. I/we also understand if we purposely give false or misleading information I/we may be fined, sentenced to jail, or both. If you are a dependent student, one parent must sign below. (Student s Signature) (Parent s/ Spouse s Signature) YOUR FORM IS NOT COMPLETE. PLEASE CONTINUE TO SECTION J V5 4
STUDENT NAME: CHOWAN ID #: High School Completion Status Provide one of the following documents to indicate the student s high school completion status when the student begins college in 2018 2019: A copy of the student s high school diploma. For students who completed secondary education in a foreign country, a copy of the secondary school leaving certificate or other similar document. A copy of the student s final official high school transcript that shows the date when the diploma was awarded. A State certificate or transcript received by a student after the student passed a State-authorized examination that the State recognizes as the equivalent of a high school diploma (GED test, HiSET, TASC, or other State-authorized examination). An academic transcript that indicates the student successfully completed at least a two-year program that is acceptable for full credit toward a bachelor s degree. For a student who was homeschooled in a State where State law requires the student to obtain a secondary school completion credential for homeschooling (other than a high school diploma or its recognized equivalent), a copy of that credential. For a student who was homeschooled in a State where State law does not require the student to obtain a secondary school completion credential for homeschooling (other than a high school diploma or its recognized equivalent), a transcript, or the equivalent, signed by the student's parent or guardian, that lists the secondary school courses the student completed and includes a statement that the student successfully completed a secondary school education in a homeschool setting. A student who is unable to obtain the documentation listed above must contact the financial aid office. J. Certification and Signatures By signing below, I/we certify the information reported on this worksheet is complete and accurate and authorize the Financial Aid Office to perform necessary electronic corrections to the FAFSA on my behalf. I/we agree to provide proof of any information reported on this form or on my FAFSA. I/we realize that any false statement or failure to give proof when asked may be cause for denial, reduction, withdrawal, and/or repayment of my financial aid. I/we also understand if we purposely give false or misleading information I/we may be fined, sentenced to jail, or both. If you are a dependent student, one parent must sign below. (Student s Signature) (Parent s/ Spouse s Signature) YOUR FORM IS NOT COMPLETE. PLEASE CONTINUE TO SECTION K You are required to complete the Identity and Statement of Educational Purpose. You must sign Section K in the presence of a Notary Public, or in the Chowan University Financial Aid Office. The ORIGINAL Copy of Section K must be received. We cannot accept a fax. Please to: V5 5
STUDENT NAME: CHOWAN ID #: K. Identity and Statement of Educational Purpose Identity and Statement of Educational Purpose (To Be Signed in the Presence of a Notary) If the student is unable to appear in person at Chowan University to verify his or her identity, the student must provide to the institution: (a) A copy of the unexpired valid government-issued photo identification (ID) that is acknowledged in the notary statement below, or that is presented to a notary, such as, but not limited to, a driver s license, other state-issued ID, or passport; and (b) The original Statement of Educational Purpose provided below, which must be notarized. If the notary statement appears on a separate page than the Statement of Educational Purpose, there must be a clear indication that the Statement of Educational Purpose was the document notarized. Statement of Educational Purpose I certify that I am the individual signing this Statement of Educational Purpose and (Print Student s Name) this Statement of Educational Purpose and that the Federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending Chowan University for 2018 2019. _ (Student s Signature) (Student s ID Number) Declaración de Propósito Educativo Certifico que yo,, soy el individuo que firma esta [Imprimir nombre del estudiante] Declaración de Propósito Educativo, y que la ayuda financiera federal estudiantil que yo pueda recibir sólo será utilizada para fines educativos y para pagar el costo de asistir a Chowan University para 2017 2018. [Firma del estudiante] [Fecha] [Número de identificación del estudiante] Notary s Certificate of Acknowledgement Notary s certification may vary by State State of City/County of On_, before me,, (Notary s name) THIS ORIGINAL FORM MUST BE RETURNED TO THE FINANCIAL AID OFFICE. COPIES CANNOT BE ACCEPTED. personally appeared,, and proved to me on the basis of satisfactory evidence (Printed name of signer) of identification to be the above-named person who signed the foregoing instrument. (Type of unexpired government-issued photo ID provided) WITNESS my hand and official seal (seal) (Notary signature) My commission expires on Please to: V5 6