701 N. Clinton Street

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Office of Financial Aid

701 N. Clinton Street

Defiance, OH 43512

Phone: 419-783-2458

Fax: 419-783-2579

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The U.S. Department of Education selected your financial aid application for a review in a process called verification. Verification is a process in which the Financial Aid Office determines the accuracy of the information provided on the FAFSA. Please provide the following information:

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1. Student Information:

______

Student Name Social Security Number

______

Email AddressPhone Number

1. Family Information:

Write the names of all family members in your household. List the name of the college if this family member will attend at least ½ time between 7/1/2014 and 6/30/2015 and will be enrolled in a degree or certification program.

Dependent Students: List the people that your parents will support between July 1, 2014 and June 30, 2015. Include yourself, your parents, and your parents’ dependent children (if your parents provide more than half support).

Independent Students: List the people that you (and your spouse) will support between July 1, 2014 and June 30, 2015. Include yourself, your spouse, and your dependent children (if you provide more than half their support).

1. Benefit Information

In 2012 or 2013, did you or anyone in your household receive benefits from any of the federal benefit programs listed below?

Supplemental Security Income Food Stamps (SNAP)

Yes No If yes, yearly amount: $______Yes No

1. Tax Information

1. Untaxed Portions of IRA Distributions and Pensions (refer to your 2013 Federal Tax Return)

In 2013, did you or anyone in your household reportuntaxed portions of IRS distributions or pensions?

Yes No

If yes, please provide the following information:

IRS Distribution Information:

IRS Form 1040-line 15a $______15b $______Was this a rollover? Yes No

IRS Form1040A-line 11a $______11b $______Was this a rollover? Yes No

Pension Information:

IRS Form 1040-lines 16a $______16b $______Was this a rollover? Yes No

IRS Form 1040A-lines 12a $______12b $______Was this a rollover? Yes No

F. Child Support Paid

Did anyone in the household pay out child support in 2013? Yes (include information below) No

Name of person who paid child support ______Amount paid in 2013 $______

Name of person(s) to whom child support was paid (list all):

______

Name(s) of children for whom child support was paid (list all):

______

(attach a separate document if needed)

G. Signatures

______

Student SignatureDateParent Signature (if dependent)Date

Warning: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.

Identity and Statement of Educational Purpose

(To Be Signed With Notary)

If the student is unable to appear in person at Defiance College to verify his or her identity, the student must provide:

(a)A copy of the valid government-issued photo identification (ID) that is acknowledged in the notary statement below, such as but not limited to a driver’s license, other state-issued ID, or passport

and

(b) The original notarized Statement of Educational Purpose provided below.

Statement of Educational Purpose

I certify that I ______am the individual signing this

(Print Student Name)

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

______for 2013-2014.

(Name of Postsecondary Educational Institution)

______

(Student Signature) (Date)

______

(Student ID Number)

Notary’s Certificate of Acknowledgement

State of ______

City/County of ______

On______, before me, ______,

(Date) (Notary name)

personally appeared, ______, and provided to me

(Printed name of signer)

on basis of satisfactory evidence of identification ______

(Type of government-issued photo ID provided)

to be the above-named person who signed the foregoing instrument.

WITNESS my hand and official seal

(seal) ______

(Notary signature)

My commission expires on ______

(Date)

How to use the IRS Data Retrieval Tool

1. Sign in at

1. Select either Continue (if you have already started a FAFSA, but have yet to submit it) or Make a Correction (if you wish to correct an already submitted FAFSA)

1. Choose the Parent Demographic Tab, scroll to the bottom of the page and click Next

1. The first question regarding tax filing status needs to be answered Already Completed

1. Review the boxes to see if any of the following circumstances apply; if not, select None of the Above.
2. You cannot use the retrieval tool if any of the following apply:
3. Married, filing separately
4. Filed as Head of Household
5. Filed an amended tax return
6. Filed a Puerto Rican or foreign tax return

1. You will be presented with the option to link to the IRS.
2. Click Link
3. Fill in filing status (choose from drop down list)
4. Fill in address information (the address information must match the address exactly as it was used to file the 2013 tax returns)
5. Select Transfer into FAFSA button

1. Once back into the FAFSA, go to the bottom of the screen and click Save, then click Next

1. For the Student’s IRS Return Retrieval, repeat steps 4-7, making sure that you have clicked on the student section.

1. Once back into the FAFSA, save and submit your FAFSA by signing with your FAFSA PIN and agreeing to their terms, then click Submit.

IRS Tax Transcript Request Process

Tax filers can request a transcript, free of charge, of their 2013 tax return from the IRS in one of three ways:

Option #1: Online Request

Available on the IRS website at

• In theOnline Servicessection of the homepage clickOrder a Tax Return Transcript
• ClickOrder a Transcript
• Enter the tax filer’s social security number, date of birth, street address, and zip or postal code.Use the address currently on file with the IRS. Generally this will be the address that was listed on the latest tax return filed. However, if an address change has been completed through the U.S. Postal Service, the IRS may have the updated address on file.
• ClickContinue
• In theType of Transcriptfield, selectReturn Transcriptand in the Tax Year field, selectthe year you are requesting.
• If successfully validated, tax filers can expect to receive a paper IRS Tax Return Transcript at the address included in their online request, within five to 10 days from the time the online request was successfully transmitted to the IRS.
• IRS Tax Return Transcripts requested online cannot be sent directly to a third party by the IRS.

Option #2: Telephone Request

• Available from the IRS by calling 1-800-908-9946
• Tax filers must follow prompts to enter their social security number and the numbers in their street address. Generally this will be numbers of the street address that was listed on the latest tax return filed.However, if an address change has been completed through the U.S. Postal Service, the IRS may have the updated address on file.
• SelectOption 2to request an IRS Tax Return Transcript and then enterthe year you are requesting.
• If successfully validated, tax filers can expect to receive a paper IRS Tax Return Transcript at the address that was used in their telephone request, within five to 10 days from the time the IRS receives the request.

Option #3

Paper Request

• Use IRS for 4506T-EZ,
• Download atirs.gov/pub/irs-pdf/f4506tez.pdf
• Mail to the appropriate address located on page 2 of the form
• Wait 5-10 days upon receipt and processing of the form for delivery of your transcript

Upon receipt of your IRS Tax Transcript, please submit to the Financial Aid Office.

Defiance College

Financial Aid Office

701 North Clinton Street

Defiance, OH 43512

Fax: 419-783-2579

Phone: 419-783-2458