Molecula

Financial Aid Office
San Jose City College
2100 Moorpark Ave
San Jose, CA 95128

2012-2013 Dependent Verification Worksheet
IMPORTANT INSTRTUCTIONS: There are two methods you may use to complete verification. Both methods require you to
submit this completed Verification Worksheet to the Financial Aid Office (FAO). Do not leave anything blank on this form.
(1) The preferred method is touse the IRS Data Retrieval Tool at www.fafsa.gov, transferring your 2011 income information
directly to your FAFSA. If you did not originally use the Tool when completing your FAFSA, you may return to the FAFSA
website (if you have filed your 2011 Federal tax return) and use the Tool to complete verification of your tax information.
(2) If you are not able to, or choose not to use the Tool, thenyou must obtain a Tax Return Transcript from the IRS and submit it
to our office. Per US Dept of Education rule, the college cannot accept a copy of your IRS tax return form. You can request a
Tax Return Transcript (not a Tax Account Transcript) at www.irs.gov or by calling the IRS automated system at 1800-908-9946. If you are unable to use the automated system for any reason, you can call theIRS at 1 -800-829-1040.

A. Student Information
Last Name

First Name

M.I.

Student ID number

Date of Birth

B. Family Information
List the people in your parents’ household. Include the following:
• Yourself and your parent(s) (including stepparent) even if you do not live with your parents
• Your parents’ other children, even if they do not live with your parent(s), and if yourparents will provide more than half of their support
from July 1, 2012 through June 30, 2013, or the children would be required to provide parental information when applying for aid
• Other people if they live with your parents, your parents will provide more than half of their support, and will continue to provide more
than half of their support from July 1, 2012 through June 30, 2013.
Writethe name of the college for household members, excluding your parent(s), who will be attending college at leas t half-time between
July 1, 2012 and June 30, 2013 and will be enrolled in a degree or certificate program. If you need more space, attach a sepa rate page.
Full Name

Age

Relationship

College or University

Self

San Jose City College

C. If you have already filed a 2011tax return…
Student Section (check one box only)
Check here if you used the IRS Data Retrieval Tool in FAFSA on the Web to transfer your tax return information onto your FAFSA
and you did not change any transferred information.
Check here if you did not file and are not required to file 2011 Federal income taxes
Check here if you are unable or choose not to use the IRS Data Retrieval Tool inFAFSA on the Web. Checking this box will require
you to submit your 2011 Federal Tax Return Transcript to FAO. Refer to the instructions for number two above.
Persons with the following circumstances are unable to use the IRS Data Retrieval Tool. Check any that apply to you.
You filed a 2011 tax return for a foreign country
You filed an amended 2011 tax return (you must request both
the TaxReturn and Tax Account Transcripts from the IRS.)
Parent(s) Section (check one box only)
Check here if your parent(s) used the IRS Data Retrieval Tool in FAFSA on the Web to transfer their tax return information to the
FAFSA and did not change any transferred information.
Check here if your parents did not file and are not required to file 2011 Federal income taxes
Check here if yourparent(s) are unable or choose not to use the IRS Data Retrieval Tool in FAFSA on the Web. Checking this box
will require you to submit your parents’ 2011 Federal Tax Return Transcripts to FAO. Refer to the instructions for number two above.
Persons with the following circumstances are unable to use the IRS Data Retrieval Tool. Check any that apply to you.
Parents marital status changed after...