Verifivation of Divorce - Georgia

2015-2016 VERIFICATION OF SEPARATION/DIVORCE
VALDOSTA STATE UNIVERSITY
OFFICE OF FINANCIAL AID
__________________________________ 870_____________________
Student's Name Student ID Number
Your parent must complete this form if their income was used on the FAFSA to determine your financial aid
eligibility. If only the student’s income was used on the FAFSA, the student should then complete this form.
I, __________________________________________,
Parent of student or student
Please check one:
( ) am divorced and not remarried. Date of divorce _____________.
Month/Year
( ) am divorced but remarried. Date of marriage _______________.
Month/Year
If you are remarried, return a copy of your current spouse’s 2014 IRS Income Tax Transcript and his/her 2014
Wage and Income Statement. Copies of all W-2 or 1099 forms may submitted instead of Wage and Income
Transcripts.
( ) am separated from my spouse and we are presently maintaining separate households. We have been
separated since ___________.
Month/Year
If you and your spouse still live in the same house or maintain separate residences due to military or employment
requirements, you are not considered separated. If you are not separated from your spouse, check the space below
and return a copy of your spouse’s 2014 IRS Income Tax Transcript and his/her 2014 Wage and Income Statement.
Copies of all W-2 or 1099 forms may submitted instead of Wage and Income Transcripts.
( ) am not divorced or separated from my spouse.
(If you check this space, stop here and mail the form to the address below.)
Please list below the financial support received from spouse if any:
$__________ child support/cash payment from spouse received in 2014.
$__________ other means of support (housing or living allowances received from spouse or anyone else)
received in 2014.
( ) I received no support from my spouse and I filed a separate tax return for 2014.
__________________________________ ______________
Signature Date
Return To: Office of Financial Aid Phone: 229-333-5935
Valdosta State University FAX: 229-333-5430
Valdosta, GA 31698
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Verifivation of Divorce - Georgia PDF

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