Dependent Verification Form 2021-2022

What you must do before financial aid can be awarded to you:

Important Note: The instructions below apply to each parent included in the household. Notify the financial aid office if the parents filed separate IRS income tax returns for 2019 or had a change in marital status after December 31, 2019.

Instructions: Complete this section if the parents filed or will file a 2019 IRS income tax return(s). The best way to verify income is by using the IRS DRT that is part of FAFSA on the Web at FAFSA.gov. In most cases, no further documentation is needed to verify 2019 income information that was transferred into the student’s FAFSA using the IRS DRT if that information was not changed by the FAFSA filer.

Select the option that best applies:*

The parent(s) have used the IRS DRT in FAFSA on the Web to transfer 2019 IRS income tax return information into the student’s FAFSA.
The parent(s) have not used the IRS DRT in FAFSA on the Web, but will use the tool to transfer 2019 IRS income tax return information into the student’s FAFSA.
The parents are unable or choose not to use the IRS DRT in FAFSA on the Web, and instead will provide the school with a 2019 IRS Tax Return Transcript(s).
The parents did not file taxes (2019). See section C for additional information.

A 2019 Tax return transcript may be obtained through:

Get Transcript by MAIL – Go to www.irs.gov, under the Tools heading, click “Get a tax transcript.” Click “Get Transcript by MAIL.” Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.” The transcript is generally received within 10 business days from the IRS’s receipt of the online request.
Get Transcript ONLINE – Go to www.irs.gov, under the Tools heading, click “Get a tax Transcript.” Click “Get Transcript ONLINE.” Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.” To use the Get Transcript Online tool, the user must have (1) access to a valid email address, (2) a text-enabled mobile phone (pay-as-you-go plans cannot be used) in the user’s name and (3) specific financial account numbers (such as a credit card number or an account number for a home mortgage or auto loan). The transcript displays online upon successful completion of the IRS’s two-step authentication.
Automated Telephone Request – 1-800-908-9946. Transcript is generally received within 10 business days from the IRS’s receipt of the telephone request.
Paper Request Form – IRS Form 4506T-EZ or IRS Form 4506-T. Transcript is generally received within 10 business days from the IRS’s receipt of the paper request form.

If your parents filed separate 2019 IRS income tax returns, the IRS DRT cannot be used and the 2019 IRS Tax Return Transcript(s) must be provided for each.*

Check here if a 2019 IRS Tax Return Transcript(s) is provided (upload below)
Check here if a 2019 IRS Tax Return Transcript(s) will be provided later.

IRS Tax Return Transcript(s)*

Drop files here or

Accepted file types: pdf, doc, docx, jpeg, jpg, png, Max. file size: 2 MB, Max. files: 3.

A. Student Information

Faulkner Student ID Number*

Name*

First Middle Last

SSN*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth*

Email*

Enter Email Confirm Email

Phone*

B. Household Information

List below the people in your parents’ household. Include:

The Student (self)
Your parents (including a stepparent) listed on the FAFSA.
The parents’ other children if the parents will provide more than half of the children’s support from July 1, 2021, through June 30, 2022, or if the other children would be required to provide parental information if they were completing a FAFSA for 2021-2022. Include children who meet either of these standards, even if a child does not live with the parents.
Other people if they now live with the parents and the parents provide more than half of the other person’s support, and will continue to provide more than half of that person’s support through June 30, 2022.
Number in College: Include in the space below information about any household member who is, or will be, enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary educational institution any time between July 1, 2021, and June 30, 2022, and include the name of the college.

Note: We may require additional documentation if we have reason to believe that the information regarding the household members enrolled in eligible postsecondary educational institutions is inaccurate.

Student (Self)

Student's Name*

First Last

Student's Age*

Student's College*

Enrolled at least half time?*

Yes
No

Parents

Parent's Name*

First Last

Parent's Age*

Parent's Name

First Last

Parent's Age

Siblings

1.) Sibling's Name

First Last

Sibling's Age

Sibling's College

Enrolled at least half time?

Yes
No

2.) Sibling's Name

First Last

Sibling's Age

Sibling's College

Enrolled at least half time?

Yes
No

3.) Sibling's Name

First Last

Sibling's Age

Sibling's College

Enrolled at least half time?

Yes
No

Are there more relationships that need to be added?

Yes, I need more room

Additional Household Members*

Please specify additional members of household below. Click on the (+) plus sign on the left of the row to add up to five household members.

Relationship	Full Name	Age	College	Enrolled half time? Yes/ No

C. Tax Return Non Filers

For parents that did not file taxes (2019). Otherwise, skip to section D.

Complete this section if the parents will not file and are not required to file a 2019 income tax return with the IRS. The instructions and certifications below apply to each parent included in the household.

Select the option that best applies:*

Both parents were unemployed and neither had income earned from work in 2019.
One or both parents were employed in 2019 and have listed below the names of all employers, the amount earned from each employer in 2019, and whether an IRS W-2 form or an equivalent document is provided. (Provide copies of all 2019 IRS W-2 forms issued to the parents by their employers). List every employer even if the employer did not issue an IRS W-2 form.

1.) Employer Name*

1.) Annual Amount Earned in 2019*

Please enter a number greater than or equal to 1.

2.) Employer Name

2.) Annual Amount Earned in 2019

3.) Employer Name

3.) Annual Amount Earned in 2019

4.) Employer Name

4.) Annual Amount Earned in 2019

Total Amount of Income Earned from Work:

This total is auto-calculated based on variables provided above.

Do you have IRS W-2 or an Equivalent Documents for the Employers specified above*

Yes (upload below)
No

IRS W-2 or an Equivalent Document*

Drop files here or

Accepted file types: pdf, doc, docx, jpeg, jpg, png, Max. file size: 2 MB, Max. files: 4.

Provide documentation from the IRS or other relevant tax authority dated on or after October 1, 2019 that indicates a 2019 IRS income tax return was not filed with the IRS or other relevant tax authority.*

Check here if confirmation of nonfiling is provided. (upload below)
Check here if confirmation of nonfiling will be provided later.

Confirmation of Non-Filing*

Accepted file types: pdf, doc, docx, jpeg, jpg, png, Max. file size: 2 MB.

D. Additional Income

Both tax filers and non-tax filers must list any untaxed income received in 2019. Be sure to enter zeros if no funds were received. Failure to complete this section will delay the processing of your verification.

Applicants with no taxable income, no earned income or no untaxed income as reported in Section D will be required to submit a Low Income Document form and letter explaining how living expenses were met.

Parents Only - Calendar Year 2019

Untaxed portion of pensions*

Untaxed portion of IRA distributions*

Tax exempt interest income*

Education credits from 1040 or 1040A*

IRA distributions*

IRA deductions and payments*

Total additional income for parents*

This total is auto-calculated based on variables provided above.

Students Only - Calendar Year 2019

Untaxed portion of pensions*

Untaxed portion of IRA distributions*

Tax exempt interest income*

Education credits from 1040 or 1040A*

IRA distributions*

IRA deductions and payments*

Total additional income for students*

This total is auto-calculated based on variables provided above.

E. Sign this Form

Signature*

By signing this worksheet, I (we) certify that all the information reported on this worksheet is complete and correct. Warning: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.

I understand

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Introduction