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THE UNIVERSITY OF OKLAHOMA

FINANCIAL AID SERVICES1000 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 thisinformation before awarding federal aid. If there are differences between your application information and thesedocuments, 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 throughJune 30, 2013. Also include other people if they now live with you and you provide more than half of theirsupport 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 duringJuly 1, 2012 through June 30, 2013.

Section C: Untaxed Income. You and your spouse must complete this section to report sources of income notsubject 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 fromflexible 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 2011calendar year. (Refer to your answer to question number 96 on your Student Aid Report.)

Part 2 asks whether your or your spouse PAID child suppo rt in 2011 because of divorce or separationor as a result of a legal requirement. Dont include support for children in your household, as reportedin question 93 on your Student Aid Report. (Refer to your answer to question 43b on your Student AidReport.)

Section E: Sign, date and return the Dependent Student Verification Worksheet to the OU Office of Financial AidServices. 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 SERVICES1000 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. Studen t Information : (To update your mailing address log in to ozone.ou.edu ,)

Last name First name M.I. Social Security Number

Address (include apt. no.) Sooner ID Number

City 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 Name of college attending in 12-13 Self

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.Student Spouse

Payments to tax-deferred pension and savings plans (paid directly or withheldfrom earnings), including, but not limited to, amounts reported on the W-2 formsin Boxes 12a through 12d, codes D, E, F, G, H and S.

IRA deductions and payments to self-employed SEP, SIMPLE, Keogh and otherqualified plans from IRS Form 1040 line 28 + line 32 OR 1040A Line 17

Child support received for all children. Do not include foster or adoptionpayments. (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 zerohere.

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Untaxed portions of pensions from IRS Form 1040 - lines (16a minus 16b) or1040A - 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 thisform. (FAFSA Question 44j)

Housing, food and other living allowances paid to members of the military, clergyand others (including cash payments and cash value of benefits. (FAFSAQuestion 44g student)

Veterans non-education benefits such as Disability, Death Pension, orDependency & Indemnity Compensation (DIC) and/or VA Educational Work-Study 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 line67. See front instruction page for what NOT to include (FAFSA Question44i)

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 theSupplemental Nutrition Assistance Program or SNAP (formerly known as food stamps) any time during the 2010or 2011 calendar years.

One of the persons listed in Section B of this worksheet received SNAP benefits in 2010 or 2011. If asked bymy 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 2011indicate below the name of the person who paid the child support, the name of the person to whom the childsupport 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 thepayment of child support. If you need more space, attach a separate page that includes your name and SocialSecurity Number at the top.

Name of Person Who PaidChild Support

Name of Person to WhomChild Support was Paid

Name of Child for WhomSupport Was Paid

Amount of ChildSupport Paid in

2011Marty Jones(example) Chris Smith Terry Jones $6,000.00

E. Sign this WorksheetBy signing this worksheet, I (we) certify that all the information reported to qualify for Federal student aid is complete and correct to thebest of our knowledge. I understand I may be required to submit additional documentation to resolve missing, conflicting or discrepantinformation. 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 th is completed form to: OU FINANCIAL AID SERVICES, 1000 Asp Avenue, Room 216, Norman, OK 73019-4078