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2015-­‐2016  Independent  Verification  

Your  2015-­‐2016  Free  Application  for  Federal  Student  Aid  (FAFSA)  was  selected  for  review  in  a  process   called  Aggregate  Verification.  Northern  is  required  to  verify  student  and/or  parent(s)  income  from  work,   non-­‐filers  information,  SNAP  (formally  known  a  food  stamps),  child  support,  high  school  completion  and   educational  identity  for  the  2015-­‐2016  academic  year  as  required  by  the  U.S.  Department  of  Education     (34  CFR,  Part  668).  

To  verify  that  accurate  information  was  provided  on  your  application,  we  will  compare  your  FAFSA  with   the  information  on  this  document  and  with  any  other  required  documents.  Northern  New  Mexico  College   reserves  the  right  to  make  all  necessary  changes  to  your  Student  Aid  Report.  

If  you  have  questions  about  the  verification  process,  please  contact  the  Financial  Aid  Office  at     (505)  747-­‐2128  or  finaid@nnmc.edu.  Failure  to  complete  the  verification  process  will  result  in     a  delay  of  financial  aid  processing  or  possible  loss  of  eligibility.    

You  and  your  spouse  (if  married)  must  complete  and  submit  this  Verification  Form,  and  any  additional  documentation   requested,  before  your  financial  aid  will  be  processed.  

STEP  1:    STUDENT  INFORMATION  

_____________________________________________________________________   ________________________________   Last  Name       First  Name       M.I.   Student  ID  

_____________________________________________________________________   ________________________________   Address  (where  you  get  your  mail)             Date  of  Birth  

_____________________________________________________________________   ________________________________   City         State     Zip       Email  

________________________________________     _______________________________________   ________________________________   Phone         OR   Message  Phone       Cell  Phone  

Step  2:    FAMILY  INFORMATION

 

List  below  the  people  in  your  household.  If  more  space  is  needed,  provide  a  separate  paper  that  includes  student   name  and  ID  on  the  top  of  page.  Include:

 

• Yourself  and  your  spouse  (if  married).  

• Your  children  or  your  spouse’s  children,  even  if  they  do  not  live  with  you,  if  you  (or  your  spouse)   will  provide  more  than  half  of  their  financial  support  from  July  1,  2015,  through  June  30,  2016)     • 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  through  June  30,  2016.  

Full  Name   Age   Relationship   College   Will  be  Enrolled   at  Least  Half  Time?  

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Student’s  Name:  ___________________________________________________   Student  ID:  __________________________   STEP  3:    STUDENT  &  SPOUSE  TAX  AND  INCOME  INFORMATION  (All  applicants)  

Instructions:  

You  must  provide  your  tax  data.  The  preferred  method  is  to  utilize  the  IRS  Data  Retrieval  Tool.  If  you  have   not  already  utilized  the  IRS  Data  Retrieval  Tool,  you  can  revise  your  FAFSA  application  to  link  your  tax  data   to  satisfy  this  requirement.  If  you  filed  your  IRS  tax  return  electronically,  it  is  generally  available  to  link  to   your  FAFSA  within  2-­‐3  weeks  of  filing.  If  you  mailed  a  paper  copy  of  your  IRS  tax  return,  data  is  available     for  transfer  6-­‐11  weeks  after  filing.  

 

If  you  are  unable  or  choose  not,  to  utilize  the  IRS  Data  Retrieval  Tool  within  the  FAFSA,  you  must  submit     a  2014  IRS  Tax  Return  Transcript.  To  obtain  your  tax  transcript,  go  to  www.irs.gov  and  select  the  option     to  Order  a  Return  Transcript.    Note:  only  Return  Transcripts  will  be  accepted  (not  Account  Transcripts).    

Need  Assistance?  Step-­‐by-­‐step  instructions  for  completing  the  IRS  Data  Retrieval  or  obtaining  your  IRS  Tax   Transcript  are  available  at  www.nnmc.edu,  Financial  Aid  section.  

TAX  FILERS  

Check  the  box  that  applies:  

I  and/or  spouse  filed  a  2014  Federal  Tax  Return  (form  1040,  1040A,  1040EZ)    

I,  the  student  have  used  the  IRS  Data  Retrieval  Tool  to  retrieve  and  transfer  2014  IRS  income   information,  either  on  the  initial  FAFSA  or  when  making  a  correction  to  the  FAFSA.  The  school   will  use  the  IRS  information  that  was  transferred  in  the  verification  process.  

 

I,  the  student  have  not  yet  used  the  IRS  Data  Retrieval  Tool  in  the  FAFSA,  but  will  use  the  tool   to  retrieve  and  transfer  2014  IRS  income  information  into  the  FAFSA,  once  I  have  filed  a  2014   IRS  tax  return.  See  instructions  above  for  information  on  how  to  use  the  IRS  Data  Retrieval   Tool.  The  school  cannot  complete  the  verification  process  until  the  IRS  information  has  been   transferred  into  the  FAFSA.  

 

I,  the  student  am  unable  or  choose  not  to  use  the  IRS  Data  Retrieval  Tool,  and  I  will  submit     to  the  school  a  2014  IRS  tax  return  transcript.  Make  sure  to  request  the  “IRS  tax  return   transcript”  and  not  the  “IRS  tax  account  transcript”.  See  instructions  above  for  information   on  how  to  use  the  IRS  Data  Retrieval  Tool.  The  school  cannot  complete  the  verification   process  until  the  IRS  information  has  been  transferred  into  the  FAFSA.  

 

Check  here  if  an  IRS  tax  return  transcript(s)  is  attached  to  this  worksheet.   NON-­‐TAX  FILERS  

 

I  am  not  required  to  file  (and  will  not  file)  a  2014  Federal  Tax  Return.    

Were  you  employed  or  did  you  receive  income  from  work  in  2014?    Yes  /  No  (circle  one)   If  you  indicated  Yes  above,  list  below  your  employer(s)  and  the  amount  earned  from  each     in  2014.  If  more  space  is  needed  please  attach  a  separate  paper  with  information.  Student’s   name  and  ID  must  be  included.  

 

Employer  Name   2014  Amount  Earned  

   

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Student’s  Name:  ___________________________________________________   Student  ID:  __________________________   STEP  4:  UNTAXED  INCOME  –  STUDENT  

Answer  each  question  below  as  it  applies  to  you,  the  student,  whose  information  is  reported  on  the  FAFSA.   If  any  item  does  not  apply,  enter  “N/A”  for  Not  Applicable  where  a  response  is  requested,  or  enter  “0”  in   an  area  where  an  amount  is  requested.  

To  determine  the  correct  annual  amount  for  each  item:    If  you  paid  or  received  the  same  dollar  amount   every  month  in  2014,  multiply  that  amount  by  the  number  of  months  in  2014  you  paid  or  received  it.  If  you   did  not  pay  or  receive  the  same  amount  each  month  in  2014,  add  together  the  amounts  you  paid  or   received  each.  

A. Payments  made  by  student  to  tax-­‐deferred  pension  and  retirement  savings  plans.  

List  any  payments  (direct  or  withheld  from  earnings)  to  tax-­‐deferred  pension  and  retirement  savings   plans  (e.g.,  401(k),  or  403(b)  plans),  including,  but  not  limited  to,  amounts  reported  on  W-­‐2  forms  in   Boxes  12a,  through  12D  with  codes  D,  E,  F,  G,  H,  and  S.  

 

Name  of  person  who  made  the  payment   Total  Amount  Paid  2014  

   

   

   

B. Child  support  received  

List  the  actual  amount  of  any  child  support  received  in  2014  for  ALL  children  listed  in  the  household   in  STEP  2  of  this  worksheet.  Do  not  include  foster  care  payments,  adoption  payments,  or  any  amount   that  was  court-­‐ordered  but  not  actually  paid.  

Name  of  person  who  received     child  support  

Name  of  child  for  whom   support  was  received    

Amount  of  child  support   received  in  2014    

     

     

C. Child  support  received  

Include   cash   payments   and/or   the   cash   value   of   benefits   received  by   you   the   student   or   student’s   parent(s).    Do  not  include  the  value  of  on-­‐base  military  housing  or  the  value  of  a  basic  military  allowance   for  housing.    

D. Veterans  non-­‐education  benefits  

List  the  total  amount  of  veteran’s  non-­‐education  benefits  received  in  2014  by  you,  Include  Disability,   Death  Pension,  Dependency  and  Indemnity  Compensation  (DIC)  and/or  VA  Educational  Work  Study   allowances.   Do   not   include   federal   educational   benefits   such   as   Montgomery   GI   Bill,   Dependent   Education  Assistance  Program.  VEAP  Benefits,  Post-­‐911  GI  Bill.    

 

Name  of  recipient     Type  of  benefit     Amount  of  benefit   received  in  2014    

     

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Name  of  recipient     Type  of  veterans    

non-­‐educational  benefit   Amount  of  benefit  received  in  2014  

     

     

     

STEP  5:    OTHER  UNTAXED  INCOME  

List  the  amounts  of  other  untaxed  income  received  by  you  the  student  that  were  not  reported  elsewhere   on  this  form.    Include  untaxed  income  such  as  workers’  compensation,  disability,  Black  Lung  Benefits,   untaxed  portion  of  health  savings  accounts  from  IRS  Form  1040  Line  25,  Railroad  Retirement  Benefits,  etc.   Do  not  include  student  aid,  Earned  Income  Credit,  Additional  Child  Tax  Credit,  Temporary  Assistance  to   Needy  Families  (TANF),  untaxed  Social  Security  Benefits,  Supplemental  Security  Income  (SSI),  Workforce   Investment  Act  (WIA)  educational  benefits,  combat  pay,  benefits  from  flexible  spending  arrangements     (e.g.,  cafeteria  plans),  foreign  income  exclusion,  or  credit  for  federal  tax  on  special  fuels  

Name  of  recipient     Type  of  other  untaxed  

income   Amount  of  benefit  received  in  2014  

     

     

     

A. Money  received  or  paid  on  the  student’s  behalf    

List  any  cash  support  received  or  paid  on  the  student’s  behalf  (e.g.,  payment  of  student’s  bills)  and   not  reported  elsewhere  on  this  form.  If  someone  is  paying  rent,  utility  bills,  etc.,  for  the  student  gives   cash,  gift  cards,  etc.,  include  the  amount  of  that  person’s  contributions.  DO  NOT  INCLUDE  SUPPORT   FROM  A  PARENT  WHOSE  INFORMATION  WAS  ALREADY  REPORTED  ON  THE  2015-­‐2016  FAFSA.   Amounts  paid  on  the  student’s  behalf  also  include  any  distributions  to  the  student  from  a  529  plan   owned  by  someone  other  than  the  student  or  the  student’s  parent(s),  such  as  grandparents,  aunts,   and  uncles  of  the  student.  

Name  of  recipient     Type  of  financial                  

support     Amount  of  benefit  received  in  2014  

     

     

B.   Additional  Information    

So  that  we  can  fully  understand  your  family  financial  situation,  please  provide  information  about  any   other  resources,  benefits,  and  other  amounts  received  by  the  student  and  any  members  of  the   student’s,  household.  This  may  include  items  that  were  not  required  to  be  reported  on  the  FAFSA  or   other  forms  submitted  to  the  Financial  Aid  Office,  and  include  such  things  as  federal  veteran’s   education  benefits,  military  housing,  SNAP,  TANF,  SSI,  WIC  etc.  

Name  of  recipient     Type  of  financial  support     Amount  received  in  2014  

     

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STEP  6:    OTHER  INFORMATION  TO  BE  VERIFIED   A.   Food  Stamp  Benefits  –  Calendar  Year  2013-­‐2014    

Complete  this  section  if  one  of  the  persons  listed  in  STEP  2  received  benefits  from  the  Supplemental   Nutrition  Assistance  Program  or  SNAP  (formally  known  as  food  stamps)  any  time  during  the  2013   and/or  2014.  

Yes  –  One  of  the  persons  listed  in  STEP  2  of  this  worksheet  received  SNAP  benefits  in  2013   and/or  2014.  If  asked  by  Northern’s  Financial  Aid  Office,  I  will  provide  documentation  of  the   receipt  of  SNAP  benefits.    

No  –  Continue  to  Section  B  

NOTE:    If  NNMC  has  reason  to  believe  that  the  information  provided  regarding  the  receipt  of  SNAP  benefits     is  inaccurate,  we  may  require  documentation  from  the  agency  that  issued  the  SNAP  benefits  in  2013  or  2014.  

 

B.   Child  Support  Paid  

Did  you  (or  spouse)  if  married  listed  in  STEP  2  pay  child  support  in  2014?  

Yes  –  I/we  paid  child  support  in  2014  and  have  listed  below  the  requested  information  for  each   child  to  whom  child  support  was  paid.    If  asked  by  Northern’s  Financial  Aid  Office,  I/we  will   provide  additional  documentation  of  the  payment  of  child  support.  (Do  not  include  child   support  paid  for  children  listed  on  your  FAFSA  as  part  of  your  household  size  or  listed  in  STEP  2   of  this  worksheet.)    

No  –  Continue  to  Step  8   Name  of  person  who  paid  

child  support  

Name  of  person  to  whom   child  support  was  paid    

Amount  child  support                                     paid  in  2014  

     

     

 

STEP  8:    CERTIFICATION  and  SIGNATURES  

We  certify  that  all  the  information  reported  on  this  worksheet  is  complete  and  correct.  The  student  must   sign  and  date  this  worksheet.  If  student  is  married,  the  spouse’s  signature  is  optional.  

 

WARNING:  If  you  purposely  give  false  or  misleading  information  on  this  form,  you  may  be  fined,  be   sentenced  to  jail  or  both.

 

 

____________________________________________________________________                    ________________________   Student  Name   Student  ID  

 

____________________________________________________________________                  ________________________  

Student  Signature   Date  

   

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