2018 Verification of Additional Financial Information

Please complete each answer for you and your parents (if dependent) or spouse (if married) as applicable.

Student Name Student Name * First Last
Simmons ID *
Student Email *
CHILD SUPPORT PAID

Enter below, the total child support paid in 2018 (because of divorce/separation or as a result of legal requirements)
Student (& spouse if applicable) *
Parent *
Taxable Earnings from Need Based Employment (Federal Workstudy)

Enter below, the amount earned in 2018 from Federal Workstudy
Student (& spouse if applicable) *
Parent *
Taxable Grants/Scholarship Aid reported to the IRS as Income

Enter below, ONLY the amount of Grants/Scholarships that were taxable and reported on your IRS 1040 form
Student (& spouse if applicable) *
Parent *
Combat or Special Combat Pay

Enter below, ONLY the amount of combat pay that was included in your 2018 adjusted gross income on your tax return
Student (& spouse if applicable) *
Parent *
Earnings from Work Under a Cooperative Education Program Offered by a College

Enter below, ONLY the amount of earnings from a formal co-op placement in a College program.
Student (& spouse if applicable)
Parent *
Certification and Signature

I certify that all of the information reported on this worksheet is complete and accurate.
(The student must sign this worksheet)
Draw your signature into the box below. *

Clear