Your application was selected, by the Federal Government, for review in a process called “Verification.” In this process, Southern will be comparing information from your application with copies of your 2018 Federal tax return transcripts, or with W-2 forms or other financial documents. If you are a dependent student we will also ask for your parents 2018 Federal Tax information. The best way to verify income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of the FAFSA on the Web at FAFSA.gov. If there are differences between your application information and your financial documents, Southern may need to make electronic corrections.

What you should do1. If you did not use the IRS Data Retrieval Tool on your FAFSA, you must submit a 2018 tax return transcript from the IRS, or a signed copy of your 1040.2. Complete and sign the worksheet. A parent signature is needed for dependent students.3. Submit the completed worksheet, tax forms, and any other documents your school requests to your financial aid administrator.4. Talk to your financial aid administrator if you have any questions about completing this worksheet.

1. STUDENT’S INFORMATION

Last 4 of SSN Date of Birth

Address City State Zip Code

Email Address Cell Phone Number

2. STUDENT’S FAMILY INFORMATION

Dependent StudentList the people in your parent(s) household, including:Yourself and your parent(s) (including step-parent), even if you don’t live with your parents. The parents’ other children if the parents will provide more than half of the children’s support from July 1, 2020, through June 30, 2021, or if the other children would be required to provide parental information if they were completing a FAFSA for 2020-2021. Include children who meet either of these standards, even if a child does not live with the parents. Other people if they now live with your parent(s), and your parent(s) provide more than half of their support and will continue to provide more than half of their support through June 30, 2021. Independent StudentList the people in your household; including yourself, and your spouse, if marriedYour children, if any, if you will provide more than half of their support from July 1, 2020 through June 30, 2021.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 from July 1, 2020 through June 30, 2021.

PLEASE NOTE: Do not list children for whom your parents or your step-parent pays child support if that child support was reported on the application. If you need more space please attach a separate page.

Student’s Name: Student’s ID:

2020 - 2021 V1 VERIFICATION WORKSHEET

Full Name

Self Southern Adventist University

Name of College(if not applicable, leave blank)

Enrolled at least half-time?

(Yes or No)Marital StatusRelationship

to StudentAgeFull Name

4. Parent’s Tax Forms and Income Information or Student’s Spouse’s information if Student is Married:

A. Check only one box below.

Check here if they used the IRS data retrieval tool through FAFSA.

Check here if they are attaching a signed copy of your 2018 IRS Federal tax return. (Signed 1040 or Tax Return Transcripts)

Check here if they did not file or were not required to file a 2018 IRS Federal tax return. (Complete letter B)B. IF YOU DID NOT FILE and were not required to file a 2018 IRS Federal Tax Return, list below your employer(s) and any income received in 2018 and attach copies of your 2018 W2’s or a signed statement.

5. Child Support Paid / Child Support Received

YES, child support was paid and/or received by the student’s parent(s) listed on the FAFSA for children living outside the household in 2018. If asked by the school, I will provide documentation of the child support paid during 2018.

Name of Person Who Paid Child Support

Name of Person to Whom Child Support was Paid

Name of Child for Whom Support Was Paid

Age of Child Total Amount of Child Support Paid in 2018

$

$

COMPLETE THE TABLE BELOW:

STUDENT SIGNATURE DATE

CERTIFICATION & SIGNATURES: Each person signing the worksheet certifies that all of the information reported is complete and correct.

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

The student and one parent must sign and date. We are unable to accept e-signed documents.

PARENT SIGNATURE (dependent students only) DATE

3. Student’s Tax Forms and Income Information (all applicants):

A. Check only one box below.

Check here if student was not employed and had no income earned from work in 2018.

Check here if you used the IRS data retrieval tool through FAFSA.

Check here if you are attaching a signed copy of your 2018 IRS Federal tax return. (Signed 1040 Tax ReturnTranscripts)

Check here if you did not file or were not required to file a 2018 IRS Federal tax return: (Complete letter B)

B. IF YOU DID NOT FILE and were not required to file a 2018 IRS Federal Tax Return, list below your employer(s) and any income received in2018 and attach copies of your 2018 W2’s or a signed statement.

Student’s Name: Student’s ID:

$

$

Sources of Income 2018 Income

$

$

Sources of Income 2018 Income

Date of Birth: Address: City: State: Zip Code: Email Address: Cell Phone Number: AgeRow1: AgeRow2: Enrolled at least halftime Yes or NoRow2: AgeRow3: SelfRow2: Southern Adventist UniversityRow2: Enrolled at least halftime Yes or NoRow3: AgeRow4: SelfRow3: Marrital StatusRow4: Southern Adventist UniversityRow3: Enrolled at least halftime Yes or NoRow4: SelfRow4: Marrital StatusRow5: Southern Adventist UniversityRow4: Enrolled at least halftime Yes or NoRow5: fill_25: fill_26: YES child support was paid by the students parents listed on the FAFSA for children living outside the household in 2018 If asked: Name of Person to Whom Child Support was PaidRow1: Name of Child for Whom Support Was PaidRow1: Age of ChildRow1: fill_27: Name of Person to Whom Child Support was PaidRow2: Name of Child for Whom Support Was PaidRow2: Age of ChildRow2: fill_28: DATE: DATE_2: Full name row 2: Full name row 3: Full name row 4: Full name row 5: Check Box14: OffSource of income: Source of income row 2: 2018 income row 2: 2018 income row 1: Text21: Text22: Text23: Text24: Students ID: First Name: Check Box1: OffCheck Box2: OffCheck Box3: OffLast 4 of SSN: Marrital StatusRow2: Marrital StatusRow001: AgeRow5: SelfRow1: Marrital StatusRow3: Southern Adventist UniversityRow1: Enrolled at least halftime Yes or NoSouthern Adventist University: 6666666: Southern Adventist UniversityRow6: Marrital StatusRow6: SelfRow6: AgeRow6: First Name 6: Group1: Off