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Student 1
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2012-2013 Income Verification Worksheet

STOP! Make Sure You Need To Fill This Out First!

Recently Filled This Form Out? It can take 1-2 business days to show as received in myPellissippi. It will also take several days for it to be processed.

  • DO NOT FILL THIS FORM OUT IF the status is "Received Pending Review" in myPellissippi. THIS WILL DELAY PROCESSING!
  • ONLY RESUBMIT THIS FORM IF the status is "Received Incomplete" in myPellissippi or told so by a staff member.
  • Already faxed or turned in this form in person? DO NOT FILL THIS FORM OUT AGAIN. THIS WILL DELAY PROCESSING!

How to Check To See If This Form Is Needed

  • Login to myPellissippi (opens in new tab/window).
  • Click on the "Registration" tab.
  • Under "Registration Information" click "Financial Aid Account Information."
  • Click on "Your Requirements."
  • Click on "Student Requirements."
  • Click the appropriate aid year:
    “Award Year 2012-2013" for Fall 2012
  • If the document is listed as "Needed" you will need to fill this form out.

If you answered NO to all the questions below on your original FAFSA, you are considered a Dependent Student. Dependent students must report their parent's income and assets as well as their own. Federal student aid programs are based on the concept that a dependent student's parents have the primary responsibility for paying for their child's education.

1. Were you born before January 1, 1989?
2. Are you married?
3. Are you a Veteran?
4. Do you have children (or dependents) that receive more than 1/2 of their support from you?
5. Were you an orphan or ward of the court until age 18?
6. Are you an emancipated minor?
7. Are you in a legal guardianship as determined by a court?
8. Are you an unaccompanied youth who is homeless as determined by the school district or director of a HUD hunded program any time after July 1, 2011?