2023-2024 Verification V1

2023-2024 Verification V1
Your Free Application for Federal Student Aid (FAFSA) was selected for review in a process called "verification". In this process, the Financial Aid Office compares the information provided on this form to the information you provided on your FAFSA. If there are any differences, your FAFSA may be corrected.

Return this form as soon as possible to avoid delays in receiving your financial aid.
Campus Location
A. Student Information
Name*

First NameMiddle NameLast Name
Student ID*
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
B. Family Information
Dependency Status: *
Your parent is required ot sign this worksheet. Please enter their contact information below. They will receive an email inviting them to complete their portion of this form and add their electronic signature. Please remind them to check their Junk email folder if the invitation does not arrive in their Inbox. This form cannot be processed without their signature.
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Marital Status*
List all the people in your household who will be supported by you between July 1, 2023 and June 30, 2024.

Be sure to include:
- Yourself, even if you don't live with your parent(s)
- Your spouse, if you are married
- Your children, if any, if you will provide for more than half of their support from 7/1/2023 through 6/30/2024.
- Other children or other people, if they now live with you and you will provide more than half of their support and will continue to provide more than half of their support from 7/1/2023 through 6/30/2024.
DO NOT INCLUDE CHILDREN FOR WHOM A LISTED PARENT PAYS CHILD SUPPORT.

DO NOT INCLUDE FOSTER CHILDREN.

Include the name of the college for any household member, excluding your parent(s), who will be enrolled at least half-time in a degree, diploma, or certificate program at a postsecondary educational institution any time between 7/1/2023 and 6/30/2024.

COMPLETE ALL BOXES (Name, Age, Relationship and College) FOR EACH FAMILY MEMBER

	Full Name	Age	Relationship	College of attendance between 7/1/23 - 6/30/2024	Will be enrolled at least half time
Family Member 1
Family Member 2
Family Member 3
Family Member 4
Family Member 5
Family Member 6

I have additional family members to add

YesNo

C. Income Information
Student (and Spouse if applicable) Tax Return Status (check one below)

Completed the IRS Data Retrieval Tool process on FAFSA2021 Tax Return (Signed) or 2021 Tax Return Transcript From the IRS2021 Federal Tax Return TranscriptFiled an IRS Tax Extension. I have or will attach a copy of the IRS Tax Extension form 4868, and IRS W-2's forms provided by all of my employers.Filed an Amended Tax Return and attached are both a signed copy of the 2021 Amended Tax Return (form 1040X) and the original 2021 Tax ReturnI did NOT file a 2021 Federal Tax return and was not required to file. Must complete section D.
On*

MonthDayYear
Date
Upload Signed Return or Transcript*

Cancelof
On*

MonthDayYear
Date
Upload all Extension Forms and W-2's here:*

Cancelof
Employer's Name*
Amount Earned*
Employer's Name
Amount Earned
Employer's Name
Amount Earned
Upload your Amended and Original tax returns here: *

Cancelof

Total amount of income earned:*
Upload W-2(s) here:

Cancelof

Total amount of income earned:*
Upload W-2(s) here:

Cancelof
NON-FILING STATEMENT: If you or your parents were not required to file taxes in 2021, please write a brief statement for each non-filer confirming you did not file taxes.*
If we have reason to believe any information on this worksheet is inaccurate, we may require additional documentation.

E. Certification and Signature

Each person signing this worksheet below certifies that all of the information reported on it is complete and correct.
WARNING: If you purposely give false or misleading information you may be fined, be sentenced to jail, or both.
Student Signature*

Clear
Date

MonthDayYear
Date
Spouse Signature (optional)

Clear
Date

MonthDayYear
Date
Parent Signature

Clear
Date

MonthDayYear
Date
Financial Aid Office Contact Information

Address: ATTN: Financial Aid Office 3240 Fort Rd., Toppenish, WA 98948 | Phone: (509) 865-8502 | Email: financial_aid@heritage.edu
Should be Empty:

	Full Name	Age	Relationship	College of attendance between 7/1/23 - 6/30/2024	Will be enrolled at least half time
Family Member 7
Family Member 8
Family Member 9
Family Member 10
Family Member 11
Family Member 12

	Employer's Name	2021 Amount Earned	IRS W-2 Uploaded?
Job 1
Job 2
Job 3
Job 4
Job 5

	Employer's Name	2021 Amount Earned	IRS W-2 Uploaded?
Job 1
Job 2
Job 3
Job 4
Job 5

2023-2024 Verification V1

A. Student Information

B. Family Information

C. Income Information

E. Certification and Signature