2016–2017 Verification Worksheet

Dependent Students receiving SNAP benefits

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 and your parents reported on your FAFSA. To verify that you provided correct information, CASC willcompare 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 and at least one parent must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the Financial Aid Office at CASC. We may need to ask for additional information.If you have questions about verification, contact theFinancial Aid Office as soon as possible so that your financial aid will not be delayed. Your application will not be processed until all of the required documents have been provided.
  1. Dependent Student’s Information

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Student’s Last Name Student’s First Name Student’s M.I.Student’s Social Security Number

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Student’s Mailing Address (include apt. no.) Student’s Date of Birth

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City State Zip CodeStudent’sHome Phone Number

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Student’s Email Address Student’s Alternate or CellPhone Number

  1. Receipt of SNAP Benefits for the Parent’s household

One of the persons listed in the Parent’s household receivedSNAP benefits in 2014 or 2015. Note: If we have reason to believe that the information regarding the receipt of SNAP benefits is inaccurate, we may require documentation from the agency that issued the SNAP benefits in 2014 or 2015.

The Parent’s household includes:

  • The student
  • The parents (including a stepparent) even if the student doesn’t live with the parents.
  • The parents’ other children if the parents will provide more than half of their support from July 1, 2016, through June 30, 2017, or if the other children would be required to provide parental information if they completed a FAFSA for 2016-2017. Include children who meet either of these standards even if the children do not live with the parents.
  • Other people if they now live with the parents and the parents provide more than half of their support and will continue to provide more than half of their support through June 30, 2017.

No one listed in the Parent’s household received SNAP benefits in 2014 or 2015.

  1. Certification and Signatures

Each person signing below certifies that all of the information reported is complete and correct. The student and one parent must sign and date.

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Student’s SignatureDate

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Parent’s SignatureDate