2011-2012 Verification Worksheet Independent Student Your application was selected by the U.S. Department of Education for review in a process called “verification.” In this process, we are required by federal law (34 CFR, Part 668) to compare your FAFSA information with information provided on this form, and with signed copies of your and your spouse’s 2010 federal tax forms. If there are differences between your application and the documents you’ve submitted, corrections may need to be made. We cannot process your financial aid until this completed worksheet, signed copies of tax forms and other relevant documents are submitted to our office.
A. Student Information ___________________________________________________ Last Name First Name M.I.
______________________________________________ Social Security Number
___________________________________________________ Address (include apt. no.)
______________________________________________ Date of Birth
___________________________________________________ City State ZIP Code
______________________________________________ Student E-mail Address
___________________________________________________ Home Phone Number
______________________________________________ Student Cell Phone Number
B. Family Information List the people in your household that you, and your spouse (if you have one), will support between July 1, 2011 and June 30, 2012. Include: • Yourself • Your spouse • Your children (if they receive more than 50% of their financial support from you) • Other people who live with and receive more than 50% of their financial support from you and will continue to through June 30, 2012 Name
1.
Age
Relationship to Student
College student will attend in 2011-2012
Self
Emmanuel College
2011-2012 Enrollment: Full-Time, Half-Time, Less Than Half-Time
Undergrad/ Grad
2. 3. 4. 5. 6. 7. Office of Student Financial Services, Emmanuel College, 400 The Fenway, Boston, MA 02115 Phone: 617-735-9938 Fax: 617-735-9939 E-mail: financialservices@emmanuel.edu Office Use Only: FCVIN11