1040Ez 2005 Federal Tax Form by pmy18725

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									                      2006-2007 Verification Worksheet - Independent
                                           Federal Student Aid Programs



      Complete both sides of this form and return to the Grand Rapids Community College Financial Aid Office, 143
      Bostwick NE, Grand Rapids, MI 49503. Attach signed copies of 2005 Federal tax returns.

A. Student Information

      Last name                First name                     M.I.                 GRCC ID# and/or Social Security Number


      ___________________________________                                          __________________________
      Address (include apt. no.)                                                   Date of birth


      City                     State                          Zip code             Phone number (include area code)

B. Family Information
List the people that you (and your spouse) will support between July 1, 2006 and June 30, 2007.
Include:
       You and your spouse, and
            Your children – if you provide more than fifty percent (50%) of their support.
            Other people in your household if they now live with and get more than half their support from you (or your
             spouse) and will continue to get this support between July 1, 2006 through June 30, 2007.

      Include with each name listed, their age and relationship to the student. Also write in the name of college for any household
      member who will be attending college at least half-time between July 1, 2006 and June 30, 2007, and will be enrolled in a
      degree, diploma, or certificate program. If you need more space, attach a separate page.

  Household Member - Full Name                          Age        RelationshipTo Student                  Current College
                                                                            Self




C. Student and Spouse Tax Forms and Income Information
 1.       The student and spouse must attach a signed copy of their 2005 FEDERAL tax return(s), (includes 2005 IRS
          Form 1040, 1040A, 1040EZ, a tax return from Puerto Rico or a foreign tax return.) If you and/or your spouse
          did not keep a copy of your tax return(s), you can request a transcript from the Internal Revenue Service
          (1-800-829-1040) or from your tax preparer.
                      Check this box if you (the student) filed a 2005 U.S. Income Tax Return. (Attach signed copy)
             OR       Check this box if you (the student) did NOT work in 2005.
             OR       Check this box if you (the student) will not file and are not required to file a 2005
                      U.S. Income Tax Return. If you checked this box, list below your employer(s) and
                      any income received in 2005.

          Sources of Income/Name of Employer                          Amount (Use W-2 or other earnings statement)
                     Check this box if your spouse filed a 2005 U.S. Income Tax Return. (Attach signed copy)

          OR         Check this box if your spouse did NOT work in 2005.
          OR         Check this box if your spouse will not file and is not required to file a 2005 U.S. Income
                     Tax Return. If you checked this box, list below the spouse’s employer(s) and any income
                     received in 2005.

        Sources of Income/Name of Employer                               Amount (Use W-2 or other earnings statement)




  2.    Amounts of untaxed income received in 2005 by student and spouse.
          If the answer to any sources listed below is zero or does not apply to you or your spouse, then
          enter 0.

                                                                  Student                                      Spouse
               Sources:                                    Amount Received in 2005                      Amount Received in 2005
 Child Support Received

 Social Security Income (SSI, Disability)

 Earned income credit (from IRS Form
 1040-line 66a; 1040A-line 41a; or l040EZ
 line 8a)

 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 1040 A-line 17)

 Tax exempt interest income (from IRS
 Form 1040-line 8b or 1040A-line 8b)

 Foreign Income exclusion (from IRS
 Form 2555-line 43 or 2555 EZ-line 18)


D. Sign this Worksheet

The College must review the requested information, under the financial aid program rules (CFR
title 34, Part 668).
If you are the student, by signing this application you certify that you (1) will use federal and /or state student financial aid only to pay the cost
of attending an institution of higher education, (2) are not in default on a federal student loan or have made satisfactory arrangements to
repay it, (3) do not owe money back on a federal student grant or have made satisfactory arrangements to repay it, (4) will notify your school
if you default on a federal student loan and (5) will not receive a Federal Pell Grant for more than one school for the same period of time.

If you are the parent or the student, by signing this application you agree, if asked, to provide information that will verify the accuracy of your
completed form. This information may include your U.S. or state income tax forms that you filed or are required to file. Also, you certify that
you understand that the Secretary of Education has the authority to verify the information reported on this application with the
Internal Revenue Service and other federal agencies. If you sign any document related to the federal student aid programs electronically
using a Personal Identification Number (PIN), you certify that you are the person identified by the PIN and have not disclosed that PIN to
anyone else.




Student                                    Date                                    WARNING: If you purposely give false or
                                                                                   misleading information on the worksheet, you
                                                                                   may be fined $20,000, sent to prison or both.
Spouse                                     Date

								
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