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THE UNIVERSITY OF OKLAHOMA

FINANCIAL AID SERVICES 1000 Asp Avenue, Room 216 Norman, Oklahoma 73019-4078 Phone (405) 325-4521 Fax (405) 325-7608

www.financialaid.ou.edu 2012-2013 UNIVERSITY OF OKLAHOMA OFFICE OF FINANCIAL AID SERVICES INDEPENDENT STUDENT VERIFICATION WORKSHEET

Your application was selected for review in a process called "Verification. By law, we have the right to ask you for this information before awarding federal aid. If there are differences between your application information and these documents, we will send corrections electronically to the Department of Education to have your information reprocessed. If you have questions about completing this worksheet, you may contact O.U. Financial Aid Services at (405) 325-4521.

Section A:

Please print clearly or type your information.

Section B:

Family Information. List the people in your household. Include: yourself, your spouse (if you have one), and your/your spouses children, if you provide more than half of their support from July 1, 2012 through June 30, 2013. Also include 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, 2012 through June 30, 2013. Do not include foster children in the household. Also write in the name of the college any household member will be attending for at least half time during July 1, 2012 through June 30, 2013.

Section C:

Untaxed Income. You and your spouse must complete this section to report sources of income not subject to federal income tax. DO NOT INCLUDE: student aid, earned income credit, child tax credit, welfare payments, untaxed Social Security benefits, WIA educational benefits, combat pay, benefits from flexible spending plans/cafeteria plans, foreign income exclusion or credit for federal tax on special fuels

Section D:

Part 1 asks whether anyone in the household received benefits from the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) at any time during the 2010 OR 2011 calendar year. (Refer to your answer to question number 96 on your Student Aid Report.) Part 2 asks whether your or your spouse PAID child support in 2011 because of divorce or separation or as a result of a legal requirement. Dont include support for children in your household, as reported in question 93 on your Student Aid Report. (Refer to your answer to question 43b on your Student Aid Report.)

Section E:

Sign, date and return the Dependent Student Verification Worksheet to the OU Office of Financial Aid Services. Keep these instructions and copies of everything you send to the financial aid office.

Complete the next two pages as instructed and return them to Financial Aid Services.

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THE UNIVERSITY OF OKLAHOMA


FINANCIAL AID SERVICES 1000 Asp Avenue, Room 216 Norman, Oklahoma 73019-4078 Phone (405) 325-4521 Fax (405) 325-7608

www.financialaid.ou.edu

2012-2013 INDEPENDENT STUDENT VERIFICATION WORKSHEET


A. Student Information: (To update your mailing address log in to ozone.ou.edu,)

Last name Address (include apt. no.) City

First name

M.I.

Social Security Number Sooner ID Number

State

Zip Code

Expected OU Graduation Date

B. Family Information: (Refer to questions 93 & 94 on your Student Aid Report and the instructions for this worksheet.) Attach additional sheets if needed to list all household members.
Full Name Age Relationship Self Name of college attending in 12-13

C. Untaxed Income: Do not leave any item blank. Enter "zero" for any item you did not receive.
Please report the TOTAL amount received during the year 2011.
Payments to tax-deferred pension and savings plans (paid directly or withheld from earnings), including, but not limited to, amounts reported on the W-2 forms in Boxes 12a through 12d, codes D, E, F, G, H and S. IRA deductions and payments to self-employed SEP, SIMPLE, Keogh and other qualified plans from IRS Form 1040 line 28 + line 32 OR 1040A Line 17

Student

Spouse

Child support received for all children. Do not include foster or adoption payments. (FAFSA Question 44c) Tax exempt interest income from IRS Form 1040 - line 8b or 1040A line 8b

Untaxed portions of IRA distributions from IRS Form 1040 - lines (15a minus 15b) or 1040Alines (11a minus 11b). Exclude rollovers. If negative, enter a zero here.

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Untaxed portions of pensions from IRS Form 1040 - lines (16a minus 16b) or 1040A - lines (12a minus 12b). Exclude rollovers. If negative, enter a zero here.

Money received, or paid on your behalf (e.g. bills), not reported elsewhere on this form. (FAFSA Question 44j) Housing, food and other living allowances paid to members of the military, clergy and others (including cash payments and cash value of benefits. (FAFSA Question 44g student) Veterans non-education benefits such as Disability, Death Pension, or Dependency & Indemnity Compensation (DIC) and/or VA Educational WorkStudy allowances. (FAFSA Question 44h student) Other untaxed income not reported, such as workers compensation, disability, etc. Include the first-time homebuyer tax credit from IRS Form 1040 line 67. See front instruction page for what NOT to include (FAFSA Question 44i)

D.

Independent Students Other Information to Be Verified

1. Complete this section if someone in the students household (listed in Section B) received benefits from the Supplemental Nutrition Assistance Program or SNAP (formerly known as food stamps) any time during the 2010 or 2011 calendar years. One of the persons listed in Section B of this worksheet received SNAP benefits in 2010 or 2011. If asked by my school, I will provide documentation of the receipt of SNAP benefits during 2010 and/or 2011. 2. Complete this section if you or your spouse, if married, paid child support in 2011. If either I, or if married my spouse who is listed in Section B of this worksheet, paid child support in 2011 indicate below the name of the person who paid the child support, the name of the person to whom the child support was paid, the names of the children for whom child support was paid, and the total annual amount of child support that was paid in 2011 for each child. If asked by my school, I will provide documentation of the payment of child support. If you need more space, attach a separate page that includes your name and Social Security Number at the top. Name of Person Who Paid Child Support Marty Jones(example) Name of Person to Whom Child Support was Paid Chris Smith Name of Child for Whom Support Was Paid Terry Jones Amount of Child Support Paid in 2011 $6,000.00

E. Sign this Worksheet


By signing this worksheet, I (we) certify that all the information reported to qualify for Federal student aid is complete and correct to the best of our knowledge. I understand I may be required to submit additional documentation to resolve missing, conflicting or discrepant information. If I purposely give false or misleading information on this worksheet I may be fined, be sentenced to jail, or both.

Students Signature

Date

Spouses Signature

Date

Return this completed form to: OU FINANCIAL AID SERVICES, 1000 Asp Avenue, Room 216, Norman, OK 73019-4078
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