List all people considered to be in your parent’s household. Include the name of the college for any household member who will be enrolled at least half time in a degree, diploma, or certificate program at a postsecondary educational institution any time between July 1, 2019, and June 30, 2020. If you need more space, attach a separate page. Include:

Yourself and your parent(s) (including stepparent) even if you don’t live with your parents –If yourparents are currently separated or divorced, then list only the parent whose information you providedon the FAFSA.

Your parents’ other children if your parent(s) will provide more than half of t their support from July 1,2019 through June 30, 2020, or if the other children would be required to provide parent information ifthey were completing a FAFSA for 2019-2020. Include children who meet either of these standards,even if they do not live with your parent(s).

Other people if they now live with your parent(s) and your parent(s) provides more than half of theirsupport and will continue to provide more than half of their support through June 30, 2020.

Full Name of Family Member Age Relationship College or University

2019-2020 Verification Form Dependent Student

Your FAFSA was selected for Verification review. Federal law requires Verification before awarding

or disbursing aid. OCCC will compare information from your FAFSA with this form.

Inaccurate or missing information will delay processing your financial aid.

A. Student’s Information (please print)

_______________________________ _______________________ ______ ____________________ ______________ Student Last Name First Name M.I. Social Security Number OCCC ID#

B. Family Household Information

Student Parent(s) (Check any that apply) Already Filed- You have already filed a 2017 U.S. Income Tax Return

Used the IRS Data Retrieval and transferred your tax return information into your FAFSA

Did not use IRS Data Retrieval and are submitting your 2016 IRS Tax Return Transcript(s) or certify you and parents were unable to obtain and are instead submitting signed federal tax return to the Financial Aid office.Will Not File and Did not Work – You are not required to file a 2016 income tax return, and you had no income earned from work in 2017. You are submitting an IRS Verification of Non-Filing Letter or certify your parents were unable to obtain IRS letter. Complete Section E.

Will Not File but Did Work – You did work in 2017, but will not and are not required to file a tax return. You are submitting copies of all W-2 Forms and IRS Verification of Non-Filing Letter or parents certify they were unable to obtain IRS letter. Complete section D.

C. 2017 Income Verification

If you or your parents filed a 2017 Income Tax Return and were unable or choose not to use the IRS Data Retrieval tool in FAFSA on the Web, you and your parent must submit a 2017 IRS tax return transcript or certify that you and your parents were unable to obtain and are instead submitting signed federal tax returns to the Financial Aid Office.

Order Tax Return Transcript, Wage and Income Transcript for W-2 data, IRS Verification ofNon-Filing Letter Online at: IRS.gov Click on “Get My Tax Record” link, or call 1-800-908-9946.

Names of 2017 Employers Student Earned-2017 Parent Earned-2017 $ $ $ $ $ $ $ $

W-2

F. Print and Sign this FormBy signing this form, you and your parents certify that all information reported on this form and supporting documents are complete and correct. If you purposely give false or misleading information, you may be fined, sentenced to jail or both.

____________ _____________________________________ Student’s Signature

_____________________________________ Date

____________ _____________________________________ Parent’s Signature

______________________________________ Date

D. Income Information for Non-Tax Filers Only - If you filed a tax return do not complete this sectionTotal Wages Earned from Work, Salaries, Tips. Attach: 2017 W2 and IRS "Verification of Non-filing letter(irs.gov) for each Parent or certify that parents were unable to obtain the IRS letter.

E. Low Income Households (Income below $10,000) If parents had no sources of income, write an explanation of how parents paid livingexpenses, or what was paid on their behalf. Such as housing or public assistance, food benefits, living with family, shelter, church, etc.