Independent Student Household Verification Form 2021-2022

Your Free Application for Federal Student Aid (FAFSA) has been selected for review in a process called “verification”. The U.S. Department of Education requires that Tidewater Community College compare the information reported by you on the FAFSA to your actual financial documents. Federal law stipulates that schools maintain the right to review this information before awarding federal aid, in order to comply with federal regulations. Any errors on your FAFSA that are discovered during the verification process will be corrected electronically by Tidewater Community College with the U.S. Department of Education.

A. Student Information

Student's Name*

First Middle Last

Student ID*

B. Household Information

List the people in your household. Include the following:

Yourself (and your spouse if you are married)
Your children, if any, if you will provide more than half of their support from July 1, 2021, through June 30, 2022, or if the child would be required to provide your information if they were completing a FAFSA for 2021-22. Include children who meet either of these standards, even if they do not live with you.
Other people if they live with you and you provide more than half of their support and will continue to provide more than half of their support through June 30, 2022.

List the people in your household, making sure to list yourself first*

First Name	Last Name	Age	Relationship to You

Will any of these household members in college during the time period described above? (Make sure to include yourself as you are the financial aid applicant.)*

Yes
No

C. Number in College

In the spaces below you should only provide information for household members that will be attending college at an eligible postsecondary institution during the time period describe above.

List your household members in college (Make sure to list yourself as you are the financial aid applicant)*

First Name	Last Name	Age	Relationship to You	College Name	Enrolled in at least 6 credits (half-time)? Yes or No

D. Certification and Signatures

Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional information is attached. The student MUST sign and date this section. I understand that purposely giving false or misleading information could result in a fine, imprisonment or both as it relates to my reporting information to the U.S. Department of Education.

Student's Signature*

Spouse's Signature (optional)