Verification of Other Dependents for Dependent Student

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Student Name*

On your 2024-2025 Free Application for Federal Student Aid (FAFSA) you marked the question, “The student has children or other people (excluding their spouse) who live with the student and receive more than half of their support from the student now and between July 1, 2024, and June 30, 2025.” Our office requires additional information to determine if this person qualifies as your dependent for federal financial aid purposes.

Section 1 - Your Dependents Other than a Child or Spouse

In the chart below, list all people that you support ONLY if they:
  • currently live with you, AND
  • receive more than half of their financial support from you, AND
  • will continue to receive more than half of their financial support from you July 1, 2024 through June 30, 2025.
  • Dependents
    Full Name
    Age
    Relationship
    Will be Enrolled in College at least half time (Yes or No)
     

    Section 2 - Sources of Financial Support for Your Dependents Other than a Child or Spouse

    Check all boxes below for each type of Financial Support the person(s) listed in Section 1 receives.
    List the name of each person who receives the support, and the monthly amount of support the person receives. (Financial support may include earnings from work, Social Security Benefits, Unemployment Benefits, Support from You, Financial Aid, Child Support Received, Etc.)
    Government Aid
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Unemployment
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Earnings from Work
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Child Support Received
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Worker’s Compensation
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Support from You
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Other Income not Listed Above
    Financial Support
    Full Name
    Amount of Support
     
    Financial Support
    Full Name
    Amount of Support
     
    Once this form is reviewed, additional documentation could be required. Final determination of your allowable household members will be made after review of all information received.
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      Section 3 – Certifications and Signatures

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