RCGC 2014–2015 Verification Worksheet V6
Student Name: _____________________________
2014–2015 Verification of
Untaxed Income Worksheet
Name: ____________________________________________________ Student I.D.# ______________________________
Address: __________________________________________________ Phone # __________________________________
Your 2014–2015 Free Application for Federal Student Aid
(FAFSA) was selected for review in a process called verification.
In this process, we are required by federal regulation (34 CFR,
668.51-61) to compare the information from your FASFA
application with the information provided on this form and your
tax information (and your spouse’s if you are married). If there are
differences, your FASFA information will be corrected. You must
complete and sign this worksheet, attach any required documents,
and submit the form and other required documents to the Office
of Financial Aid. We cannot process your financial aid until
verification has been completed.
Instructions: If the student, par ent(s) and/or spouse has filed a 2013
IRS income tax return(s) the Office of Financial Aid must verify the tax
income.
 Complete this verification form and submit it to the Office of
Financial Aid as soon as possible. The financial aid office cannot
process your application without this information
 The best way to verify income is by utilizing the IRS DATA
retrieval tool located within the financial section of the FAFSA
via the Web at FAFSA.gov.
 If IRS data retrieval tool is not available, you must obtain an
IRS tax transcripts) via IRS.gov.
Important Note: The instr uctions above apply to each student, par ent
(s) and/or spouse included in the household. Notify the Office of Financial
Aid if the student, parents(s) and/or spouse filed separate IRS income
tax returns for 2013.
A. Household Size (List all household members as defined below)
If Dependent:
If Independent:
 The student.
 The student.
 The parents (including a stepparent and adoptive parent) even
 The student’s spouse, if the student is married.
if the student doesn’t live with the parents.
 All biological parents that live in the household.
 Other children if the parents will provide more than half of the
children’s support from July 1, 2014 through June 30, 2015.
 Other people if they now live with the parents and the parents
provide more than half of the other people’s support and will
continue to provide more than half of their support through
June 30, 2015.
 The student’s or spouse’s children if the student or spouse
will provide more than half of the children’s support from
July 1, 2014 through June 30, 2015, even if the children
do not live with the student.
 Other people if they now live with the student and the student
or spouse provides more than half of the other people’s
support and will continue to provide more than half of their
support through June 30, 2015.
Number in College:
Include below information about any household member and indicate those who will be enrolled at least half time in a degree, diploma,
or certificate program at an eligible postsecondary educational institution any time between July 1, 2014 and June 30, 2015, include the
name of the college.
Full Name of Household Member
Age
Relationship to student
Will attend college at least
half-time in 2014-2015?
If yes, name of college
Do not include parents
EXAMPLE: the student
EXAMPLE: Joyce Miller
Self
48
Parent
Yes [ X ] No [
]
Yes [
] No [ X ]
1.
Yes [
] No [
]
2.
Yes [
] No [
]
3.
Yes [
] No [
]
4.
Yes [
] No [
]
5.
Yes [
] No [
]
6.
Yes [
] No [
]
7.
Yes [
] No [
]
RCGC
*If more space is needed, provide a separate page with the student’s name and ID number at the top.
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RCGC 2014–2015 Verification Worksheet V6
Student Name: _____________________________
B. Other Untaxed Income
*If any item does not apply enter “N/A” where a response is requested or enter “0” if an amount is requested .
Students
Parents/
Spouses
Attach
W–2s
Attach
W–2s
Payments to tax deferred pension and savings plans (paid directly or withheld from earnings.)
(Found on W–2 forms in Boxes 12a through 12d, codes D, E, F, G, H and S)
Child support received for all children. Don’t include foster or adoption payments.
$
$
$
$
$
$
$
$
Housing, food and other living allowances paid to members of the military, clergy or others.
(Including cash payments and cash value benefits). Don’t include the value of on-base military
housing or the value of a basic military allowance for housing.
Veterans non-education benefits such as Disability, Death Pension or Dependency & Indemnity
Compensation (DI) and/or VA Educational Work-Study allowances.
Other untaxed income not reported, such as worker’s compensation, disability, untaxed portions
of health savings accounts from IRS Form 1040 Line 25, etc.
*Students Only
Money received, or paid on your behalf (e.g., bills), not reported elsewhere on this form. This include money
that you received from a parent whose financial information is not reported on this form and that is not part
of a legal child support agreement.
529 plan that is owned by someone other than you and your parents
$
C. Verification of 2013 Income Information for Non-tax Filers
If you filed a 2013 federal tax return, do not complete this section.
Complete this section only if student, parent(s), or spouse will not file and are not required to file a 2013 income tax return
with the IRS.
Check the box that applies:
The student and/or spouse were not employed and had no income earned from work in 2013.
The parent(s) were not employed and had no income earned from work in 2013.
List below the names of non-tax filers, names of all employers, the amount earned from each employer in 2013
and whether an IRS W-2 form is provided.
PROVIDE COPIES OF ALL 2013 IRS W–2 FORMS ISSUED TO HOUSEHOLD MEMBERS
LISTED BELOW BY THEIR EMPLOYERS.
Name of Household Member
Employer’s Name
2013
Amount
Earned
IRS W–2 Provided?
John Doe
Suzy’s Auto Body Shop (example)
$2,000.00
Yes
4-2014
RCGC 2014–2015 Verification Worksheet V6
Student Name: _____________________________
Notes
Instructions for Printing an IRS Tax Return Transcript
To print a 2013 IRS Tax Return Transcript, go to IRS.gov and click on the Get Transcript of your Tax Records link.
 If obtaining your transcript online, you will need to make an account with the IRS. They will need personal information
including, but not limited to: social security number, street address and date of birth.
 They will also ask you to create security questions and to verify your identity.
 After opening the PDF, you may print your Tax Return Transcript.

Please ensure that if you are using a pop-up blocker on your browser that it is turned off for this website.
Individuals Granted a Filing Extension by the IRS
If an individual is required to file a 2013 IRS income tax return and has been granted a filing extension by the IRS,
provide the following documents:
 A copy of IRS Form 4868, “Application for Automatic Extension of Time to File U.S. Individual Income Tax Return,”
that was filed with the IRS for tax year 2013.
 A copy of the IRS’s approval of an extension beyond the automatic six-month extension if the individual requested an
additional extension of the filing time for tax year 2013.
Also Required
 A copy of IRS Form W–2 for each source of employment income received for tax year 2013 and, if self-employed,
a signed statement certifying the amount of the individual’s Adjusted Gross Income (AGI) and the U.S. income tax
paid for tax year 2013.
Individuals Who Filed an Amended IRS Income Tax Return
If an individual filed an amended IRS income tax return for tax year 2013, provide both of the following:

A signed copy of the original 2013 IRS income tax return that was filed with the IRS or a 2013 IRS Tax Return
Transcript or the 2013 tax year .

A signed copy of the 2013 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was filed
with the IRS.
Individuals Who Were Victims of IRS Identity Theft
A victim of IRS identity theft who is not able to obtain a 2013 IRS Tax Return Transcript or use the IRS Data
Retrieval Tool must contact the IRS at 1-800-908-4490. Upon authentication of the tax filer’s identity, the IRS
will provide, by U.S. Postal Service, a printout of the tax filer’s 2013 IRS income tax return information.
Individuals Who Filed Non-IRS Income Tax Returns
An individual filed or will file a 2013 income tax return with Puerto Rico, another U.S. territory (e.g., Guam, American
Samoa, the U.S. Virgin Islands, the Northern Marianas Islands), or with a foreign country, must provide a signed copy
of that 2013 income tax return(s).
Each person signing below certifies that all of the information reported is complete and correct.
Independent Students: The student must sign and date.
Dependent Students: The student and one parent whose information was
reported on the FAFSA must sign and date.
Student’s Signature
Date
Parent’s Signature (dependent students only)
Date
WARNING: If you purposely give
false or information you may be
fined, be sentenced to jail, or both.
Return completed and signed form to:
Rowan College at Gloucester County
Office of Financial Aid
1400 Tanyard Road
Sewell, NJ 08080
4-2014