Soka University of America – Office of Financial Aid
Income Information Worksheet (V4 Custom)
2016-2017
VERIF
SNAP Verification
Please answer the following question: Did a member of your family receive benefits from the SNAP (or
“Food Stamps”) program in 2015? (An answer is required.)
_____ Yes. Sign this form and attach proof of benefits received. Example: printout of account balance,
_____ showing names and dates.
_____ No. We will update your FAFSA to correct your information as needed.
Verification of Child Support
Name of Person Who Paid
Child Support
Name of Person to Whom
Child Support was Paid
Name of Child for Whom
Support was Paid
Amount Paid in 2015
TOTAL ________________________
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2016-2017
VERIF
Soka University of America – Office of Financial Aid
Verification of Identity or Education Purpose
Please visit Soka University of America’s Office of Financial Aid to verify your identity by presenting a valid
government-issued photo identification (ID), such as a driver’s license, other state-issued ID, or passport. A
copy of your identification will be made for your financial aid file.
You must sign, in the presence of the institutional official, the Statement of Educational Purpose provided below.
If you are unable to appear in person at Soka University of America to verify your identity, you must provide:
(a) A copy of the valid government-issued photo identification (ID) that is acknowledged in the notary statement
below or that is presented to a notary, such as, but not limited to, a driver’s license, other state-issued ID, or
passport; and
(b) The NOTARIZED original Statement of Educational Purpose, which is provided below. If the notary
statement appears on a separate page than the Statement of Educational Purpose, there must be a clear
indication that the Statement of Educational Purpose was the document notarized.
Statement of Educational Purpose: (Please sign in the presence of notary or SUA Financial Aid Official)
I certify that I ______________________________________ (print your full name) am the individual signing this
Statement of Educational Purpose and that the federal student financial assistance I may receive will only be used for
educational purposes and to pay the cost of attending Soka University of America for 2016–2017.
________________________________
Student Signature (Required)
________________________________
Date
________________________________
Student ID Number
Notary’s certificate of knowledge*
State of ________________________ City/County of __________________________ on_____________________,
(Date)
before me, ________________________________, personally appeared, __________________________________________,
(Name of Notary)
(Printed name of signer)
and proved to me on basis of satisfactory evidence of identification __________________________________________
(Type of government-issued photo ID provided
to be the above-named person who signed the foregoing instrument.
WITNESS my hand and official seal ________________________________________
(Notary signature)
(seal)
My commission expires on _________________________
(Date)
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Soka University of America – Office of Financial Aid
Verification of Highschool Completion
2016-2017
VERIF
Please submit documentation of high school completion or its equivalent and check the applicable box.
1. _____
A copy of the student’s high school diploma
2. _____
_____
A copy of the student’s final and OFFICIAL high school transcript that shows the date when the
diploma was awarded
3. _____
_____
A state certificate or transcript received by a student after the student passed a State authorized
examination that the State recognizes as the equivalent of a high school diploma.
4. _____
_____
For students who completed secondary education in a foreign country, a copy of the “secondary
school leaving certificate” or other similar document
5. _____
_____
An academic transcript that indicates the student successfully completed at least a two-year program
that is acceptable for full credit toward a bachelor’s degree
6. _____
_____
_____
For a homeschooled student in a state where state law requires the student to obtain a
secondary school completion credential for homeschool (other than a high school diploma or its
recognized equivalent), a copy of that credential
7. _____
_____
_____
_____
_____
For a homeschooled student in a state where state law does not require the student to obtain a
secondary school completion credential for homeschool (other than a high school diploma or its
recognized equivalent), a transcript or the equivalent, signed by the student's parent or guardian, that
lists the secondary school courses the student completed and includes a statement that the student
successfully completed a secondary school education in a homeschool setting.
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Soka University of America – Office of Financial Aid
Verification Checklist
1. _____
Verification of SNAP - Complete pg 1 of this document
2. _____
Verification of Child Support Paid - Complete pg 1 of this document
3. _____
Verification of Identity or Education Purpose- Complete pg 2 of this document
4. _____
Verification of High School Completion- Complete pg 3
5. _____
Certification- Complete pg 5 of this document
2016-2017
VERIF
You will be notified of any additional documentation required by the Office of Financial Aid via email or your Soka
Account’s ‘To-Do’ list. Please provide any documentation that is required as quickly as possible to avoid any
delays to your verification process.
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2016-2017
VERIF
Soka University of America – Office of Financial Aid
Certification
By Signing Below I/(We) certify the following:
1. I understand that by submitting a FAFSA I have given Soka University of America the right and obligation to
request this information.
2. I have read, understood, and followed all instructions on all pages of this form.
3. Where supporting documentation or explanation is required, I have attached it.
4. All of the information that I have provided on this form and supporting documents is true and accurate.
5. If further information is requested, I agree to provide it.
6. I understand that any Financial Aid already awarded for the academic year in question will be cancelled if
this request is not complied in a complete and timely manner.
7. I understand that any pending Financial Aid decisions will continue to be delayed until I respond to this
request.
8. I understand that any Financial Aid cancelled or not awarded as a result of untimely or incomplete
submission of this form may not be recoverable.
9. I understand that, to the extent that the information submitted on this form differs significantly from the
information that I provided on the FAFSA originally used to award aid, the Financial Aid package for the
academic year in question may change.
By signing this form, I affirm that all information on this form and any attachments are complete and accurate to the
best of my knowledge. If requested, I agree to provide documentation to support the information I have provided on
this form. I understand that any false statements or misrepresentation may be cause for denial, reduction, withdrawal,
and/or repayment of financial aid, and I may be subject to a fine, imprisonment or both, under provisions of the United
States Criminal Code.
____________________________________________________________
________________________________
Student Signature (Required)
Date
____________________________________________________________
________________________________
Parent Signature (Required)
Date
Please mail or deliver in-person this form and any supporting documents. SUA will not be responsible for any data breach if you choose
to submit information through email and we may still request that you submit original documents.
OFFICE OF FINANCIAL AID
1 UNIVERSITY DRIVE
www.soka.edu/financialaid
ALISO VIEJO, CA 92656
[email protected]
(949) 480-4342
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