Enter your JCC ID: J00
FA 2324 AVRD
DEPENDENT VERIFICATION
Your federal aid application (FAFSA) was selected for a process called “verification.” This process requires the college to
review and confirm certain information reported on your FAFSA. The financial aid office will compare your FAFSA with
information on this worksheet and other required documents. If there are differences, the financial aid office may need to
correct your FAFSA. Please do not make changes to your FAFSA at this time unless using the IRS Data Retrieval Tool or
advised to do so by the financial aid office. Note: Federal regulations give the financial aid office authority to request this
information before awarding federal aid (34 CFR, Part 668). This includes Federal Direct Student & Parent (PLUS) loans.
***The verification process can take 3-6 weeks to complete depending on when all required documentation is received.
Student’s name (First, MI, Last) Student’s phone number Parent’s phone number
Street address City State Zip
Verify Number of Household - Members Include:
yourself, even if you don’t live with your parents,
your parents (including a stepparent) reported on your FAFSA even if you do not live with your parent(s),
other children for whom your parents will provide more than half of the financial support from 7/1/23 – 6/30/24,
other children that would be required to use your parent(s) information on a 2023-24 FAFSA, if they attended college,
even if they do not reside with your parents,
Other people who live with your parents and who will receive more than half of their financial support from your
parents through 6/30/2024.
Verify Number in College: Include information about any household member who is, or will be, enrolled at least halftime (at least
6 credit hours) in a degree, diploma, or certificate program at an eligible postsecondary educational institution any time between
July 1, 2023, and June 30, 2024. Provide the name of the college.
Do not leave Age and Relationship to Student blank. Incomplete forms will not be processed.
Full Name of each household
member
Age
Relationship
to Student
Attending college
at least half-time?
Name of College
(if attending at least half-time)
I am the student YES NO Jamestown Community College
YES NO
YES NO
YES NO
YES NO
YES NO
Check this box and attach a separate page with student’s name and JCC ID number at the top if more space is needed.
Certification
I certify that all information provided in this document is true, complete and accurate. I understand that if I
purposely give false or misleading information, I may be fined, sentenced to jail or both.
Student signature: Date:
Parent signature: Date:
JCC Financial Aid Office | PO Box 20 | Jamestown, NY 14702-0020
Jamestown 716.338.1009 | 1.800.388.8557 ext. 1009 | FAX 716.338.1459 | Olean 716.376.7512 | 1.800.388.8557 ext. 7512
