1040Ez Federal Forms by flz24219

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									               West Chester University
               Office of Financial Aid
               Kershner Student Services Center, Room 030
               25 University Avenue
               West Chester, PA 19383                                                                   Independent
               (610) 436-2627  FAX (610) 436-2574
               E-MAIL: finaid@wcupa.edu



                                   2010 – 2011 Verification Worksheet

Your application for financial aid was selected for review by the U.S. Department of Education in a process called verification.
We will compare information from your FAFSA with signed copies of both you and your spouse’s (if applicable) 2009 Federal tax
forms and this verification worksheet. In accordance with federal law, WCU must request this information from you before
disbursing federal aid. If there are differences between your FAFSA application and your financial documents, we will
electronically correct your FAFSA.

What You Must Do:

[ ] 1. Complete this worksheet in full. Do not leave blanks. You must sign this form.

[ ] 2. Attach a signed, legible copy of both you and your spouse’s, (if married), 2009 Federal 1040, 1040A, 1040EZ, including
       all W2 forms, 1099’s, Schedules, Attachments and Statements, etc. If you did not retain your tax forms you can phone the
       I.R.S. for a free copy of your tax transcript with w-2’s at 800-829-1040. DO NOT send state or local tax forms.

[ ] 3. Submit the completed worksheet with all of the documents to our office within 30 days.

      **Failure to submit all the documents requested will result in the delay or cancellation of any potential financial aid.**


__________________________________________________________________                            __________________
 Student’s Last Name           First Name            M.I.                                       WCU ID or SSN


___________________________________________________________________                           __________________
  Address                         City            State       Zip                               Phone# (no dorm)


A.   Household Information

    List below the name and age of each person that you will support between July 1, 2010 & June 30, 2011. Include yourself,
your spouse (if married), and your children if you provide more than one-half of their support. You may include other people IF
they now live with you AND will continue to live with and receive more than one-half of their support from you between July 1,
2010 & June 30, 2011.
    List the names of any colleges that any household member listed below will be attending on at least a half time basis in an
eligible program of study for the 2010-2011 academic year.
 First Name & Last Name                          Age       Relationship to Student          Name of College Attending
                                                                                             (between 7-1-10 to 6-30-11)
 Example: John Doe                               18        Student                          e.g.,West Chester University
B. Student/Spouse 2009 Income Information

   1. Current marital status: _______________ If separated/divorced, provide date: _____________

   2. Check only one box below:

           [ ] I/We filed a 2009 Federal 1040, 1040A or 1040EZ
                Attach a signed 1040/A/EZ with all W-2’s, 1099’s, statements/schedules & attachments, etc.

           [ ] I/We had income, but will not file, and are not required to file a 2009 federal 1040, 1040A, 1040EZ
               Attach all W-2’s and 1099’s

           [ ] I/We had no earnings or taxable income in 2009

   3. Total 2009 Child Support you (and/or your spouse) RECEIVED $________________.
      Give Name(s) and age(s) of children: ______________________________________________________

   4. Total 2009 Child Support you (or your spouse) PAID (Not the same as #3 above). $_______________
      Give Name(s) and age(s) of children: _______________________________________________________

   5. Housing, food and other living allowances paid to military, clergy and others (including cash payments and cash value of
      benefits). Don’t include on base housing or basic military housing allowance $_________________

   6. Veterans noneducation benefits such as Disability, Death Pension, or Dependency & Indemnity Compensation (DIC)
      and/or VA Educational Work-Study allowances. $_________________

   7. Other untaxed income such as workers compensation, private disability/pension, etc. $_____________________

   8. Money received, or bills in your name paid by others, not reported elsewhere on this form. $___________________

                                Note: DO NOT report Social Security Benefits anywhere on this form




   C. Signatures


 X____________________________________________________________
      Student                              Date


 X____________________________________________________________
      Spouse (if applicable)                Date

                By signing this worksheet, I/We certify that all the information reported on it is complete and correct.


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



 RAF/raf

 Rev 01/25/10

								
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