2013-2014 V1 Dependent Verification Worksheet

Your 2013-2014 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify that you provided correct information our office will compare your FAFSA with the information on this worksheet and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the Student Finance Office. National Louis University may ask for additional information. If you have questions about verification, contact our office as soon as possible so that your financial aid will not be delayed.

Fields marked with an asterisk (*) are required fields

Dependent Student's Information
First Name: *
Last Name: *
NLU ID Number: * (Example: N00123456)
Date of Birth: * / /
Address: *
City: *
State: *
Zip: *
Email: *
Phone Number: *
Alternate Phone Number:
Parent Date of birth: * / /
Family Information

List the people in your parent(s)' household, including:

  • Yourself
  • Your parent(s) (including your stepparent) even if you don't live with your parent(s)
  • Your parent(s)' children if your parent(s) will provide more than half of their support from July 1, 2013 through June 30, 2014 (even if they don't live with your parents)
  • Other people who live with your parent(s) and your parent(s) provide more than half of their support and will continue to from July 1, 2013 through June 30, 2014

List the name of the college for any household member, excluding your parent(s), who will be enrolled at least half-time, in a degree, diploma, or certificate program at a postsecondary educational institution any time between July 1, 2013 and June 30, 2014. Do not list any non-relative, extended family members, boyfriends, girlfriends, fiancés, or roommates unless they are claimed as a dependent on your parent(s)' taxes.

Full Name: Age: Relationship
to Student:
College: Will be Enrolled
at least Half-Time:
* *
Dependent Student's Income Information to be Verified

If you are unable to use the IRS Data Retrieval Tool when submitting your FAFSA, you must submit a 2012 IRS Tax Return Transcript (not the original Income Tax Return) by contacting the IRS at 1-800-908-9946 or requesting it at www.irs.gov.

(Required to Check One)

Please attach here:

Date requested:
Parent(s)' Income Information to be Verified

If your parent(s) are unable to use the IRS Data Retrieval Tool when submitting your FAFSA, they must submit a 2012 IRS Tax Return Transcript (not the original Income Tax Return) by contacting the IRS at 1-800-908-9946 or requesting it at www.irs.gov.

Parent(s) check only one box below. (Required to Check One)

Please attach here:

Date requested:
Parent(s)' Other Information to be Verified
        * Check here if anyone in the parent(s)' household (listed in Section B) received benefits from the Supplemental Nutrition Assistance Program (SNAP/formerly known as food stamps) any time during the 2011 or 2012 calendar years. (Note: If we have reason to believe that the information regarding the receipt of SNAP is inaccurate, we may require documentation from the agency that issued the SNAP benefits in 2011 or 2012).
        * Did you or your spouse pay child support in 2012?
Certification and Signature
By printing my name below, I certify that all of the information reported on this worksheet is complete and correct.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
Student Signature: *
Parent Signature: *
Locations
  • CHICAGO DOWNTOWN CAMPUS

    NLU’s Chicago campus on South Michigan Avenue occupies five floors of the historic Peoples Gas Building. This landmark building, across the street from the Art Institute of Chicago and Grant Park, is easily accessible by train, bus and car and is surrounded by restaurants, parking lots/garages and shops.

    122 S. Michigan Avenue
    Chicago, IL 60603
    (888) 658.8632
    Info » | Directions »
  • ELGIN

    Conveniently located in a fast-growing business district off I-90 and Route 31, NLU Elgin features 10 classrooms with high-tech media equipment; a computer lab with high-speed Internet access; two conference rooms; and comfortable student lounges. Parking is free at this recently remodeled and upgraded teaching site, which now includes wireless Internet access.

    620 Tollgate Road
    Elgin, IL 60123
    (888) 658.8632
    Info » | Directions »
  • NORTH SHORE

    Opened in the summer of 2006, NLU North Shore at Skokie is a state-of-the-art modern campus located just off the Edens Expressway near the Old Orchard Shopping Center. The campus includes 44 wireless classrooms equipped with high-tech media equipment; four computer labs with high-speed Internet access, including a walk-in lab in the library; six conference rooms; a public café for beverages and snacks; a student welcome center; a library for research and study; and multiple, comfortable student lounge areas.

    5202 Old Orchard Road
    Skokie, IL 60077
    (888) 658.8632
    Info » | Directions »
  • LISLE

    Located just minutes from the East-West Tollway (I-88), NLU Lisle features 42 wireless classrooms equipped with high-tech media equipment; four computer labs with high-speed Internet access, including a separate walk-in lab in the library; a café for beverages and snacks; a student welcome center; a library for research and study; conference rooms; and six comfortable student lounge areas with wireless access.

    850 Warrenville Road
    Lisle, IL 60532
    (888) 658.8632
    Info » | Directions »
  • WHEELING

    Located in one of Chicago's major northwest suburbs, the newly renovated NLU Wheeling includes 20 classrooms with high-tech media equipment, four conference rooms, four computer labs with high-speed Internet access, large student lounge areas with wireless capabilities and interactive video capabilities, and an extensive research library. The site also houses the university library research collection.

    1000 Capitol Drive
    Wheeling, IL 60090
    (888) 658.8632
    Info » | Directions »
  • FLORIDA (TAMPA)

    Established in 1988 and located in one of the city's major business districts, NLU's Florida Regional Center serves students in 13 counties in central Florida. In addition to six classrooms, this location features a conference room, a computer lab with high-speed Internet access, an extensive research library and comfortable student lounges.

    5110 Eisenhower Boulevard Suite 102
    Tampa, FL 33634
    (800) 366.6581
    Info » | Directions »
  • WISCONSIN

    NLU's Milwaukee campus has a proud history of serving graduate students in education in southeastern Wisconsin. Nearly one in five certified Wisconsin teachers looks to NLU for graduate education programs – more than any other university in the state. In addition to classrooms with high-tech media equipment, the campus offers a state-of-the-art computer lab with wireless Internet access and an extensive IDS research library.

    12000 West Park Place, Suite 100
    Milwaukee, WI 53224-3007
    (414) 577.2658
    Info » | Directions »