Office of Financial Aid

1860 Lincoln Street

6th Floor, Room 623

Denver, CO 80203

Phone: 720-423-4744

EmilyGriffith.edu

2016-2017Child Support Paid Verification Worksheet

Student Name: ______Student ID#: ______

Email: ______Phone Number: (_____)______

Your 2016–2017 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify that you provided correct information, we will compare your FAFSA with the information on this worksheet and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to us. We may ask for additional information. If you have questions about verification, contact us as soon as possible so that your financial aid will not be delayed.

Incomplete documents will not be accepted by our office. Supporting documentation must be provided for this form to be considered complete.

Name of Person Who Paid Child Support / Name of Person to Whom Child Support was Paid / Name and Age of Child for Whom Support Was Paid / Annual Amount of Child Support Paid in 2015
Total Amount of Child Support Paid / $

Acceptable Child Support Paid documentation:Please check the appropriate box

Copy of the separation agreement or divorce decree that shows the amount of child support to be provided.

Please provide copies of child support check payment.

Notarized statement from the individual receiving the child support showing the amount provided.

By signing this document, I certify that all the information reported on this form is complete, true and accurate. I understand that purposely providing false or misleading information could result in criminal prosecution, prison sentence, and/or a fine pursuant to U.S. Criminal Code and Colorado Criminal Code. I affirm that I have read, understand, and agree to this form in its entirety and that the information supplied is true and complete.

Student:______

Print NameSignatureDate

Parent:______

Print NameSignatureDate