INDEP VERWRKST Financial Aid Office University of California Santa Barbara

INDEP-VERWRKST 2008-2009 Financial Aid Office University of California, Santa Barbara Santa Barbara, CA 93106-3180 www.finaid.ucsb.edu (805) 893-2432 Date Received: Logged in by: Evaluated by: Evaluated on: Revised 4/8/2008 2008-2009 INDEPENDENT VERIFICATION WORKSHEET UC SANTA BARBARA FINANCIAL AID OFFICE A. Student Information Perm Number Last Name (PRINT) First Name M.I. Social Security Number Address (include apartment number) Date of Birth City State ZIP Code Phone Number (include area code) Your application was selected for review in a process called “Verification.” This process requires that we compare information from your application with signed copies of your 2007 Federal Tax forms or other financial documents. Federal regulations authorize the Financial Aid Office to request this information before awarding Federal Aid. If there are differences between your application information and your financial documents, we will send these corrections electronically to the application processor to have your information reprocessed. Complete all 4 pages of this verification form, attach all tax forms, schedules and any other requested documents, and submit it to the Financial Aid Office at the address above as soon as possible. Submit all the requested information together. Failure to submit signed tax returns will result in our office requesting a federal tax transcript from the IRS. INCOMPLETE FORMS AND DOCUMENTS WILL CAUSE PROCESSING DELAYS. B. Family Information List the people in your household; include: • Yourself (and your spouse) • Your children, if you will provide more than half of their support from July 1, 2008 through June 30, 2009 • Other people if they now live with you and you provide more than half of their support and will continue to provide more than half of their support from July 1, 2008 through June 30, 2009. Write the name of the college for any household member who will be attending college at least half time between July 1, 2008 and June 30, 2009, and will be enrolled in a degree or certificate program. If you need more space, attach a separate page. The “number in family” and “number in college” you reported on your FAFSA are printed in the boxes below. If the “number in family” and “number in college” that you list in the table below differ from what you reported on the FAFSA, please explain this difference in the space provided at the bottom of the page. Number in Family as reported on FAFSA Number in College as reported on FAFSA Full Name (list student on first line) 1. 2. 3. 4. 5. 6. 7. Age Relationship to Student Self Name of College (if applicable) UCSB Explanation of any changes to family size or number in college: C. Student (and Spouse) Tax Return and W-2 Request Attach a SIGNED and COMPLETE copy of your and your spouse’s 2007 Federal Income Tax Return that was submitted to the IRS and W-2s provided by your employer to this form. BE SURE TO INCLUDE COPIES OF ALL LETTERED AND NUMBERED SCHEDULES filed with the IRS. If you and/or your spouse did not keep a copy of the Federal Income Tax Return(s), a copy can be requested from your tax preparer. You may also request a copy from the IRS by submitting IRS Form 4506T or by calling (800)829-1040. DO NOT SUBMIT A COPY OF STATE TAX RETURNS. Please check ALL boxes below that pertain to you and your spouse’s filing status. To determine if you are required to file a Federal Tax Return, see part one of the IRS publication 17 at www.irs.gov/pub/irs-pdf/p17.pdf. Carefully read the instructions below each filing status as a guide to ensure that the copy of the 2007 Federal Income Tax Return you or your spouse are submitting is complete. Complete tax returns including all lettered Schedules and Forms are required. Incomplete tax returns will prevent the processing of your financial aid. Did not work in 2007 This is pertaining to individuals who did not earn wages in 2007. Student Spouse □ Student □ Spouse Worked but did not file a federal tax return This is pertaining to individuals who earned wages but are not required to file a federal tax return. If you worked but are not required to file a 2007 federal tax return, please attach a copy of your employer provided W-2(s). □ □ If you did not or will not file please provide an explanation: _______________________________________________________ Filed a tax extension Form 4868 Tax Extension (Be aware that you are only eligible for a quarter’s worth of Alternative Loan until we receive a completed Federal Tax Return). Student Spouse □ Student □ Spouse 1040 A/EZ The form must be signed and dated by the appropriate filer(s). If there is an amount on 1040EZ line 1or 1040A line 7, please attach a copy of all employers provided W-2(s). □ Student □ Spouse 1040 The form must be signed and dated by the appropriate filer(s). Below you will see potential Schedules and Forms associated with filing a 1040. If you were required to file any Forms or Schedules, please attach a copy. If there is an amount on 1040 line 7, please submit a copy of all employer provided W-2(s). Schedule A – Itemized Deductions Schedule B – Interest and Ordinary Dividends Schedule C/CEZ – Profit or Loss from Business Schedule D – Capital Gains and Losses Schedule E – Supplemental Income and Loss • If the tax return includes an amount on Schedule E line 28 for income/losses from a Partnership, include a copy of the Form 1065 and the Schedule K-1 (Form 1065).* • If the return includes an amount on Schedule E line 28 for income/losses from a Sub Chapter S Corporation, include a copy of the Form 1120S and the Schedule K-1 (Form 1120S).* *You may need to request these forms from your tax preparer Schedule F – Profit or Loss from Farming Schedule SE – Self-Employment Tax All numbered forms such as: 4797, 4562, 6252, 4684, 6781, 8824, all lettered schedules, etc. □ □ Puerto Rican or Foreign Tax Return Form must be signed and dated by you (and spouse). Attach a certified English translation of the tax return and conversion to US dollars. Student Spouse □ □ □ □ D. Student (and Spouse) 2007 Untaxed Benefits INSTRUCTIONS: 1.) Read each line in each FAFSA worksheet and provide the annual 2007 figures. If applicable, enter $0 for each line that does not apply to you. 2.) Total the “Student” and “Spouse” columns separately and write the totals in the bold boxes. 3.) Compare the totals in the bold boxes to the amounts originally reported on the FAFSA. If these figures are different, please explain in the space provided below each section. FAFSA Worksheet A - Report Annual Amounts for 2007. Enter “$0”, if applicable. Earned income credit from IRS Form 1040 – line 66a; 1040A –line 40a; 1040EZ – line 8a Additional child tax credit from IRS Form 1040 – line 68 or 1040A - line 41 Welfare benefits, including Temporary Assistance for Needy Families (TANF). Don’t include food stamps or subsidized housing. Social Security Benefits received, for all household members as reported in student’s household size that were not taxed (such as SSI). Report benefits paid to student (and spouse) in the student’s column. Student $ $ $ $ Spouse $ $ $ $ Total- Total student and spouse amounts separately; enter zero if applicable $ $ Amount reported on FAFSA Worksheet A $ $ Please compare the “Total” to the “Amount reported on the FAFSA Worksheet A.” If there is a difference between the “Total” and the “Amount reported on FAFSA Worksheet A,” explain in the space provided below. If this does not apply, please write not applicable or N/A in the space provided below. FAFSA Worksheet B - Report Annual Amounts for 2007. Enter “$0”, if applicable. Payments to tax-deferred pension and savings plans (paid directly or withheld from earnings), including, but not limited to, amounts reported on the W-2 Form in Box 12A-12D, codes D, E, F, G, H and S. IRA deductions and payments to self-employed SEP, SIMPLE and Keogh and other qualified plans from IRS Form 1040 – total of lines 28+32 or 1040A – line 17 Child support received for all children. Don’t include foster care or adoption payments Tax exempt interest income from IRS Form 1040 – line 8b or 1040A – line 8b Foreign income exclusion from IRS Form 2555 – line 45 or 2555EZ - line 18 Untaxed portions of IRA distributions from IRS Form 1040 – lines (15a minus 15b) or 1040A – lines (11a minus 11b) excluding rollovers. If negative, enter a zero here. Untaxed portions of pensions from IRS Form 1040 – lines (16a minus 16b) or 1040A – lines (12a minus 12b) excluding rollovers. If negative, enter a zero here. Credit for federal tax on special fuels from IRS Form 4136 – line17 – nonfarmers only. Housing, food, and other living allowances paid to members of the military, clergy, and others (including cash payments and cash value of benefits). Veterans noneducation benefits such as Disability, Death Pension, or Dependency & Indemnity Compensation (DIC) and/or VA Educational Work/Study allowances Any other untaxed income or benefits not reported elsewhere on Worksheets A and B, such as worker’s compensation, untaxed portions of railroad retirement benefits, Black Lung Benefits, disability, etc. Don’t include student aid, Workforce Investment Act educational benefits, or benefits from flexible spending arrangements, e.g. cafeteria plans. Tax filers only: report combat pay not included in adjusted gross income. Money received, or paid on your behalf (e.g., bills), not reported elsewhere on this form. $ $ $ $ $ $ $ $ $ $ Student Spouse $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ xxxxxxx Total- Total student and spouse amounts separately; enter zero if applicable Amount reported on FAFSA Worksheet B $ $ Please compare the “Total” to the “Amount reported on the FAFSA Worksheet B.” If there is a difference between the “Total” and the “Amount reported on FAFSA Worksheet B,” explain in the space provided below. If this does not apply, please write not applicable or N/A in the space provided below. FAFSA Worksheet C - Report Annual Amounts for 2007. Enter “$0”, if applicable. Education credits (Hope and Lifetime Learning tax credits) from IRS Form 1040 – line 49 or 1040A – line 31 Child support paid because of divorce or separation or as a result of a legal requirement. Do not include support for children in your (or your spouse’s) household. Taxable earnings from need-based employment programs, such as Federal Work-Study and needbased employment portions of fellowships and assistantships. Student grant and scholarship aid reported to the IRS in your (or your spouse’s) adjusted gross income. Includes AmeriCorps benefits (awards, living allowances, and interest accrual payments), as well as grant or scholarship portions of fellowships and assistantships. Student $ $ $ $ Spouse $ $ $ $ Total- Total student and spouse amounts separately enter zero if applicable $ $ Amount reported on FAFSA Worksheet C $ $ Please compare the “Total” to the “Amount reported on the FAFSA Worksheet C.” If there is a difference between the “Total” and the “Amount reported on FAFSA Worksheet C,” explain in the space provided below. If this does not apply, please write not applicable or N/A in the space provided below. DID YOU REMEMBER TO: □ Fill in all blanks and enter “$0” or “N/A” when necessary? □ Provide explanations for differences between amounts reported on this worksheet and amounts reported on the FAFSA? □ Attach SIGNED* and COMPLETE tax returns with all applicable forms and schedules? □ Submit all employer provided W-2(s)? *Failure to submit signed tax returns will result in our office requiring that you submit a federal tax transcript from the IRS. E. Sign This Worksheet I certify that the information I have provided is true and complete to the best of my knowledge. I agree to provide proof supporting the information on this form, if requested. I certify that any copies of tax returns that I have provided are true copies of the documents as filed with the IRS. I realize that giving false or misleading information may result in a $20,000 fine, a prison sentence, or both. The Secretary of Education has the authority to verify information reported on this application with the Internal Revenue Service and other federal agencies. Student’s Signature: Spouse’s Signature: Date: Date: