/2011-2012Verification_Assets

Valencia College Office of Student Financial Assistance 2011-2012 Verification Worksheet

For Staff Use Only

VRWKST

Your application was selected for Verification; therefore, Valencia College is required to compare information from your application with signed copies of your and your spouse’s and/or your parent’s 2010 federal tax forms and/or other financial documents. Federal law requires that this is done before awarding federal aid (34 CFR, Part 668).

What you should do: Collect your, your spouse’s or your parents’ (if applicable) financial documents (signed Federal tax form, etc).

If you have questions concerning this form or your financial aid, contact the Answer Center on your campus for help.

Bring this completed worksheet to Valencia College along with your SIGNED tax forms and any other documents requested as soon as possible, so that your financial aid processing can resume.

What our office will do: Financial Aid Specialists will compare the information on the documents and submit any corrections that need to be made electronically to the Federal Processor.

Once we receive the corrected information, we will be able to award your financial aid as long as you are otherwise eligible.

This takes approximately 7 to 10 business days.

A. Student Information

LAST NAME

FIRST NAME

M.I.

VALENCIA ID#

STREET ADDRESS or PO BOX

CITY

DATE OF BIRTH

STATE

ZIP CODE

HOME PHONE (INCLUDE AREA CODE)

B. Family Information ■ INDEPENDENT – List the people in your household. Include:      

yourself your spouse (if married) your children, if you will provide more than half of their support from July 1, 2011 through June 30, 2012, even if they do not live with you, and; Anyone else living in your house, if you will provide more than half of their support from July 1, 2011 through June 30, 2012 and will continue to do so through June 30, 2012.

Also write in the name of the college for any household member, excluding your parent(s), who will be attending at least half time between July 1, 2011 and June 30, 2012, and will be enrolled in a degree, diploma, or certificate program.

►DEPENDENT – List the people in your parent’s household. Include:     

yourself your parent(s) whose information you provided on the financial aid application (including step-parent) your parents’ other children, even if they don’t live with your parent(s), if (a) your parents will provide more than half of their support from July 1, 2011 through June 30, 2012, or (b) the children would be required to provide parental information when applying for Federal Student Aid, and Anyone else living in your parent(s) house, if your parent(s) will provide more than half of their support from July 1, 2011 through June 30, 2012 and will continue to do so through June 30, 2012.

Also write in the name of the college for any sibling(s), excluding your parent(s), who will be attending at least half time between July 1, 2011 and June 30, 2012, and will be enrolled in a degree, diploma, or certificate program.

Full Name Student:

Age

Relationship

College

Self

Valencia College

C. Student Tax and Income Information 1. TAX FILERS – If requested by Valencia, submit signed copies of your (and your spouse’s if married) 2010 federal income tax returns (1040, 1040A, 1040EZ) to the Answer Center. Please make sure that all forms have dated signatures and are submitted in their entirety. Also make sure your (the student’s) VID or Social Security Number is on each form. If you did not keep a copy of the tax return, request a copy from the Internal Revenue Service (1-800-829-1040) or a copy from your tax preparer.

Check here if you are attaching a signed copy of a 2010 U.S Federal income tax return.

Check here if you will not file and are not required to file a 2010 Federal income tax return Check here if taxes were not requested by Valencia because you retrieved your tax information from the IRS 2. If you did not file and are not required to file a 2010 U.S. Federal income tax return, list below your employer(s) and any income received in 2010 (use the W-2 form or other earning statements if available). Do not leave any blanks; use zero or N/A if not applicable.

Sources

2010 Amount $ $ $

3. Funds received for child support and other untaxed income. Do not leave any blanks; use zero or N/A if not applicable.

Sources of Untaxed Income a. Child Support Received b. Workman’s Compensation c. Untaxed Pensions

2010 Amount $

Sources of Untaxed Income d. Tax Deferred Pensions

2010 Amount $

$ $

e. f.

$ $

D. Parent(s) or Spouse Tax Forms and Income Information 2. TAX FILERS – If requested by Valencia, submit signed copies of your (and your spouse’s if married) 2010 federal income tax returns (1040, 1040A, 1040EZ) to the Answer Center. Please make sure that all forms have dated signatures and are submitted in their entirety. Also make sure your (the student’s) VID or Social Security Number is on each form. If you did not keep a copy of the tax return, request a copy from the Internal Revenue Service (1-800-829-1040) or a copy from your tax preparer.

Check here if you are attaching a signed copy of a 2010 U.S Federal income tax return.

Check here if you will not file and are not required to file a 2010 Federal income tax return Check here if taxes were not requested by Valencia because you retrieved your tax information from the IRS 2. If you did not file and are not required to file a 2010 U.S. Federal income tax return, list below your employer(s) and any income received in 2010 (use the W-2 form or other earning statements if available). Do not leave any blanks; use zero or N/A if not applicable.

Sources

2010 Amount $ $ $

3. Funds received for child support and other untaxed income. Do not leave any blanks; use zero or N/A if not applicable.

Sources of Untaxed Income 2010 Amount Sources of Untaxed Income 2010 Amount a. Child Support Received d. Tax Deferred Pensions $ $ b. Workman’s Compensation c. Untaxed Pensions

e. f.

$ $

$ $

E. Signature By signing this worksheet, I (We) certify that all of the information reported on it is complete and correct. I (We) further understand that purposely giving false or misleading information regarding eligibility for Federal aid may result in fines, jail terms, or both.

Student’s Signature:

Date

Parent (step-parent) Signature

Date

Spouse Signature (optional)

Date

Parent(step-parent) Name

Date

Parent/Step-parent signature must be the parent whose income information was used to file the FAFSA. If you are DEPENDENT you must include parental information along with parental signature(s).

RETURN THIS FORM TO THE ANSWER CENTER – DO NOT FORGET SIGNED TAX RETURNS

Valencia College Office of Student Financial Assistance Asset Verification Form 2011-2012 1.

2.

3.

4.

5.

Please provide the information below as of the date you signed your Free Application for Federal Student Aid (FAFSA).

If you were required to provide parental information on your FAFSA, complete both student and parent sections below.

If you were married when you filed the FAFSA, include you and your spouse’s information below.

Additional information or documentation may be requested, if necessary, to complete your file.

Please DO NOT leave any boxes blank; write “0” if the asset type does not apply. If any items are missing or left blank, this form will be returned to you.

Asset Type

Student and/or Spouse Assets

Parent Assets

$

$

$

$

$

$

1. Cash, Savings and Checking accounts

2. Investments Net Worth (value minus debt) Real Estate (do not include the home you live in) Trust funds, money market funds and mutual funds Certificates of deposit, stocks, stock options, bonds, other securities, education IRAs, 529 college savings plans, and refund value of 529 prepaid tuition plans Installment and land sale contracts (including mortgages held) DO NOT INCLUDE life insurance, retirement plans (pension funds, annuities, or non-education IRAs)

3. Business and Investment Farm Net Worth (value minus debt) Market value of land, buildings, machinery, equipment, and inventory DO NOT INCLUDE the value of a family farm that you (your spouse and/or your parents) live on and operate DO NOT INCLUDE the value of a small business that you (your spouse and/or your parents) own and control and that has 100 or fewer full-time or full-time equivalent employees

CERTIFICATION STATEMENT I certify that the submitted information is true and correct to the best of my knowledge and belief. If asked, I agree to provide proof of the information provided on this form. I understand that purposely providing false or misleading information on this form may result in reduction or repayment of aid, fines, and/or imprisonment in this and/or future years.

Student VID # __________________________________________________

STUDENT SIGNATURE

DATE

PARENT SIGNATURE (ONLY IF PARENT INFORMATION WAS REQUIRED ON THE FAFSA)

DATE

Return completed and signed form to the Answer Center on your campus or mail to: Office of Student Financial Assistance Valencia College 1800 S. Kirkman Road Orlando, Fl 32811

For Staff Use Only

ASSETS