2016-2017 OTHER UNTAXED
INCOME VERIFICATION
800 US HWY 29 N, Athens, GA 30601
fax(706)425-3086
Student Information
Last
First
MI
SSN
SID
According to the Federal Guidelines, the income and support reported on the FAFSA are not sufficient to
provide for the number in the household listed on the FAFSA. Please complete the worksheet and make sure
to account for ANY support that the household might be receiving.
If the student was required to provide parental information on the FAFSA answer each question below as it applies
to the student and the student’s parent(s) whose information is on the FAFSA.
If the student was not required to provide parental information on the FAFSA, answer each question below as it
applies to the student (and the student’s spouse, if married) whose information is on the FAFSA.
Please tell us how you provided for the items listed below for your family between Jan.1, 2015 and Dec.31, 2015:
Amount/Month
Annual Amount
Housing
$
$
Electricity
$
$
Food
$
$
Clothing
$
$
Medical Expenses
$
$
Transportation
Other
Please specify:
$
$
$
$
Source of support
As set forth in its student catalog, Athens Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender,
religion, disability, age, political affiliation or belief, genetic information, veteran status, or citizenship status (except in those special circumstances
permitted or mandated by law).
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2016-2017 OTHER UNTAXED
INCOME VERIFICATION
800 US HWY 29 N, Athens, GA 30601
fax(706)425-3086
Student Information
Last
First
MI
SSN
SID
Any additional Support not addressed
In the space below, please tell us how your household is ‘getting by’ if you do not take advantage of any of the
above support.
As set forth in its student catalog, Athens Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender,
religion, disability, age, political affiliation or belief, genetic information, veteran status, or citizenship status (except in those special circumstances
permitted or mandated by law).
Page 2 of 2