PLEASE COMPLETE AND RETURN

OFFICE OF FINANCIAL AID FAX 207.893.6699

278 WHITES BRIDGE ROAD TEL 800.752.1266

STANDISH, ME 04084 207.893.6612

www.sjcme.edu/finaid EMAIL

2016-2017 VERIFICATION WORKSHEET

Please complete all sections of this form for the 2016-17 academic year. This form is required for financial aid consideration for any semester or course(s) beginning between June 1, 2016 and May 31, 2017. The College will be comparing the information on this form with the information you provided on the FAFSA. You may be asked to verify additional items at a later date.

1.  Student Information

Name______SS# ______

Address______DOB______

Daytime Phone______E-Mail ______

2.  Untaxed Income Received and Child Support Paid Questions

a.  Did you or anyone in your household receive Supplemental Nutrition Assistance (formerly known as Food Stamps) in 2014 or 2015? Yes ____ No ____

b.  Did you, your spouse (if you are married) or your parent(s) (if you are a dependent) receive any untaxed income in 2015? Yes ___ No ___. If yes, please provide the information requested in this table:

Type of Untaxed Income / Name of Person Who Received the Untaxed Income / Total Amount Received in 2015

c.  Did you, your spouse (if you are married) or your parent(s) (if you are dependent) pay any child support in 2015? Yes ____ No ____ If yes, please provide the information requested in this table:

Annual Amount Paid / Name of the Person Who Paid the Support / Name of the Person to Whom the Support Was Paid / Names of Child for Whom Child Support Was Paid

PLEASE TURN OVER

1.  Family Information – Confirm all of the household members that you reported on the FAFSA by completing the chart below. See the definitions provided which explain who can be included in the household for a dependent student or for an independent student. Only the “parent(s)” reported on the FAFSA should be included.

Are you a DEPENDENT Student? You were born on or after January 1, 1993, are unmarried, are an undergraduate and are without dependents. List all the people in your parent’s household, including:

·  Yourself (even if you don’t live with your parent),

·  Your parent(s) including stepparent, if your custodial parent is remarried,

·  Your parent’s children and stepchildren, if parent(s) provides more than half their support,

·  Other people if they now live in your parent’s household and parent(s) are providing and will continue to provide more than half of their support from July 1, 2016 through June 30, 2017.

Or are you an INDEPENDENT Student? You were born prior to January 1, 1993, are married, are a graduate student, have qualifying dependents, are homeless, are an orphan, are/were in foster care, legal guardianship or are/were a ward of the court. List all the people in your household, including:

·  Student and student’s spouse,

·  Children, if student provides more than half their support, and

·  Other people if they now live in your household and student will provide more than half their support from July 1, 2016 through June 30, 2017.

Based on the definitions above, complete all fields in the following chart:

NAME / AGE / RELATIONSHIP TO STUDENT / NAME OF COLLEGE IF ATTENDING IN 2016-17 (must be enrolled at least half-time in a degree or certificate program) / YEAR IN COLLEGE
(e.g.,
Sophomore)
SJC Student’s Name: / Self / Saint Joseph’s College

2.  I/We attest that the information on this worksheet is complete and correct. You may be asked to provide additional documentation of your responses. If student is “dependent” at least one parent must sign. Warning: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.

STUDENT’S SIGNATURE ______DATE ______

PARENT’S SIGNATURE ______DATE ______

(Dependent students only)(We CANNOT accept digital signatures)