2024-2025
Academic Year
Independent Verification Worksheet
Student’s Name: _____________________
                CHARLETTE    CARPENTER              Student ID:_________
                                                                2674286
Your Free Application for Federal Student Aid (FAFSA) was selected for a process called verification. Please answer the
following questions to verify information reported on your FAFSA, then electronically sign the document by pressing
‘Sign’ and submit the form by clicking ‘Finish’.
                                                   MARITAL STATUS
What was your marital status as of the date you filed your FAFSA?
 Single (Never Married)                                Divorced
 Married (Not Separated)                               Separated
 Remarried                                             Widowed
Extended family members or other individuals (such as your adult siblings, nieces, nephews, etc.) may be included only if
they live with you AND receive more than half their support from you during the school year. Extended family members
should not be listed in the family size if they are:
•       Working/employed/self-employed
•       Receiving means-tested benefits (SNAP, TANF, WIC, subsidized housing, etc.)
•       Receiving pensions/retirement
•       Receive Social Security Income or Disability payments
To claim you support an individual who is receiving any of the benefits listed above, your total financial support must
exceed the amount they receive from these sources. Please consider these sources of income carefully before
claiming that you support extended family members or other individuals more than 50%.
                                                          FAMILY SIZE
List the people in your household, including:
     • Yourself (and your spouse, if applicable).
     • Your children only if you and/or your spouse will provide more than half of their support from July 1, 2024 through
         June 30, 2025.
     • Other people if they now live with you AND you or your spouse provided more than half of their support and will
         continue to provide more than half of their support from July 1, 2024 through June 30, 2025.
     • DO NOT INCLUDE ANY UNBORN CHILDREN IN THE FAMILY SIZE.
    Name of Family Member                    Relationship to Student                Date of Birth    Email Address
CHARLETTE      CARPENTER                                Self                        05/16/1985
      Check here if more space is needed and you would like to add an attachment.
                                                                Student 2022 Income Information
           Were you a resident of the United States in 2022?                Yes    No
                 I filed a 2022 Tax Return.
           If married or remarried, did you file your 2022 federal tax returns jointly with your spouse?          Yes     No
                                                              OR
           Complete this section if you DID NOT file a 2022 Tax Return.
                 I, __________________
                    CHARLETTECARPENTER am not required to file a 2022 Tax Return.
                             Student’s Name
           Did you have any earnings, other income, or receive any resources that supported you during the 2022 tax
           year?
                     Yes             No
           If so, please list all sources and dollar amounts below.
                                          Employer’s Name or other source                      Total Amount received in    W2 Issued?
                                                                                                        2022
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                   Spouse 2022 Income Information
           Spouse’s SSN: ___________
           Was your spouse a resident of the United States in 2022?                     Yes       No
                 My spouse filed a 2022 Tax Return.
                                                                       OR
           Complete this section if you DID NOT file a 2022 Tax Return.
                 My Spouse, __________________ was not required to file a 2022 Tax Return. (complete if applicable)
                                              Spouse’s Name
           Did your spouse have any earnings, other income, or receive any resources that supported your spouse during
           the 2022 tax year?
                  Yes            No
           If so, please list all sources and dollar amounts below.
                                          Employer’s Name or other source                      Total Amount received in    W2 Issued?
                                                                                                        2022
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
                                                                                              U.S. $                      Yes    No
FTPTransferComplete
4
247
Independent
2025
1-18661-2408544-PROD
INDVER25    Verification Worksheet
                                                     CERTIFICATION
By signing below, I acknowledge and confirm that the above information is complete and correct. Purposely giving false
or misleading information may result in federal fines, jail sentence, or both.
_____________________________________
                              07/03/2024
  Student                   Date