Fill Your Michigan Verification Student Template

The Michigan Verification Student Form is a crucial document used to confirm the enrollment, attendance, and academic progress of students applying for or receiving public assistance. This form is essential for families participating in the Family Independence Program, as it helps ensure that children aged 6-18 are attending school full-time. To avoid potential denial or reduction of benefits, it is important to complete and submit this form promptly.

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Documents used along the form

The Michigan Verification Student form is an essential document for verifying a student's enrollment and attendance, especially for those receiving or applying for public assistance. Alongside this form, several other documents are commonly utilized to ensure comprehensive verification and compliance with regulations. Below are four key forms that often accompany the Michigan Verification Student form.

Proof of Residency: This document establishes the student's current address and may include utility bills, lease agreements, or government correspondence. It confirms that the student resides at the address provided, which is crucial for determining eligibility for assistance programs.
School Enrollment Verification: This form is typically issued by the school and confirms that the student is officially enrolled. It includes details such as the enrollment date, grade level, and status, ensuring that the student's information aligns with the requirements of public assistance programs.
Bill of Sale Form: This document is crucial for recording the transfer of ownership of personal property. For more information, you can access the Illinois PDF Forms.
Attendance Records: These records provide a detailed account of the student's attendance history. They help demonstrate compliance with attendance requirements for assistance programs and may include dates of absence and reasons for those absences.
Income Verification: This document outlines the family's income and financial status. It is often required to assess eligibility for public assistance and may include pay stubs, tax returns, or benefit statements from other programs.

Utilizing these additional forms in conjunction with the Michigan Verification Student form can streamline the verification process and enhance the accuracy of information submitted to the Department of Human Services. Proper documentation is key to ensuring that students receive the support they need without unnecessary delays or complications.

Michigan Verification Student Preview

ENTER ADDRESSEE NAME ENTER ADDRESSEE CARE OF

ENTER ADDRESSEE PO BOX OR STREET ENTER ADDRESSEE CITY/STATE/ZIP

Case Name:
Case Number:
Date:
DHS Office:
Specialist / ID:	/
Phone:
Fax:
Individual ID:

Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area. AUTHORITY: Act 280 of 1939, as amended, and Title IV and XIX of the Social Security Act.

COMPLETION: The school administration's voluntary cooperation is requested.

PENALTY: None for the school administration’s refusal to fill out form. However, failure of school to provide information may result in denial, reduction, or loss of assistance for client.

VERIFICATION OF STUDENT INFORMATION

Student Name

Student’s Birthdate

Date Completed

CLIENT INSTRUCTIONS & RELEASE OF INFORMATION:

•It is necessary to verify school enrollment, attendance and progress for students who are receiving or applying for public assistance. For the Family Independence Program, all children between the ages of 6-18 are expected to be attending school full-time or benefits may be denied, reduced, or terminated.

•This form must be completed by the school. Sign below, then take or mail the form and the return envelope to the school.

• It is your responsibility to have the form completed and returned to your worker by	or your
benefits may be denied, reduced, or terminated.

To school official: You are authorized to release the information requested below to the Department of Human Services.

Client Signature

Date

INSTRUCTIONS FOR SCHOOL OFFICIAL:

We are requesting your help in verifying enrollment, attendance and progress of the above-referenced student. Please complete the information on the back of this form and return it to our office. A stamped self-addressed envelope has been enclosed for that purpose.

TO BE COMPLETED BY SCHOOL OFFICIAL:

	1.	Name of School

	Address of School					City

	2.	Name of Responsible Person With Whom the Student is Residing				3. Relationship to Student

	4.	Address of Student's Home				City

	5.	Enrollment Status:
		FULL TIME STUDENT	HALF TIME STUDENT	LESS THAN HALF TIME			NOT CURRENTLY ENROLLED
	6.	Attendance:					Since (Give Date)
		REGULARLY ATTENDING	ATTENDING SOMETIMES	NOT ATTENDING
	If not regularly attending, is absence due to disability or periods of extended illness?				Yes	No
DHS-3380 (Rev. 10-12) Previous edition obsolete. MS Word				1

Case Name

Case Number

Specialist

7.	Type of Program
							VOCATIONAL TRADE OR TECHNICAL TRAINING
	K-12		COLLEGE OR UNIVERSITY				YES	NO	Is a High School diploma/GED Required for this program
8.	Curriculum or Major	Participating in Work Study				School Year/Term/Semester Begin Date				End Date
				YES	NO

9.	Degree Being Pursued:		ASSOCIATE OF ARTS DEGREE			NOT APPLICABLE				Expected Date of Completion/Graduation
	HIGH SCHOOL DIPLOMA		B.A./B.S			OTHER (Specify)

21 Day Compliance Test

Complete if box is checked

10. Has the child regularly attended all school days for the past 21 calendar days?

Yes

11. Comments

12. Signature of School Official

Title

Phone Number

Date

DHS-3380 (Rev. 10-12) Previous edition obsolete. MS Word

Similar forms

Student Aid Report (SAR): Similar to the Michigan Verification Student form, the SAR provides information about a student’s financial aid eligibility. It requires verification of enrollment and attendance, ensuring that students meet the criteria for receiving aid.
Living Will Form: To establish your healthcare preferences when you cannot communicate, refer to the comprehensive Living Will documentation guide that ensures your wishes are respected.
Free Application for Federal Student Aid (FAFSA): The FAFSA collects information about a student's financial situation and enrollment status. Like the Michigan form, it is essential for determining eligibility for public assistance and financial aid.
Verification Worksheet: This document is used to confirm the information provided on the FAFSA. It requires details about enrollment and attendance, paralleling the verification process outlined in the Michigan form.
Enrollment Verification Request: Schools often use this form to confirm a student's enrollment status for various purposes, including financial aid and insurance. It shares the same goal of validating student information.
Certificate of Enrollment: Issued by educational institutions, this document certifies that a student is enrolled. Similar to the Michigan form, it serves as proof of attendance necessary for public assistance.
Attendance Verification Form: This form is used to track a student's attendance record, ensuring compliance with attendance requirements for assistance programs, much like the Michigan form.
Public Assistance Application: When applying for public assistance, applicants must verify their enrollment and attendance. This application shares similarities with the Michigan form in its purpose to confirm eligibility.
Income Verification Form: While primarily focused on income, this form may also require information about student enrollment and attendance to assess eligibility for assistance programs, akin to the Michigan form.
High School Transcript: A transcript provides a record of a student’s academic performance and enrollment status. It serves a similar function in verifying a student’s educational background as the Michigan form.
State Grant Application: This application requires verification of enrollment and attendance to determine eligibility for state-funded educational grants, aligning closely with the objectives of the Michigan form.

Misconceptions

Misconceptions about the Michigan Verification Student form can lead to confusion for both students and schools. Here are four common misunderstandings:

Misconception 1: The form is mandatory for all students.

This is not true. The form is specifically required for students applying for or receiving public assistance. If a student is not in this category, they do not need to complete the form.

Misconception 2: Schools face penalties for not filling out the form.

While schools are encouraged to complete the form, there are no penalties for refusing to do so. However, not providing the information may affect the student's assistance.

Misconception 3: The form only verifies enrollment status.

The form serves multiple purposes. It verifies not only enrollment but also attendance and academic progress. All these factors are crucial for determining eligibility for assistance.

Misconception 4: Parents or guardians must submit the form themselves.

In fact, it is the responsibility of the school to complete and return the form. Parents should ensure the school receives it, but they do not need to submit it directly.

Detailed Instructions for Using Michigan Verification Student

Completing the Michigan Verification Student form is an important step in ensuring that student information is accurately reported for public assistance purposes. After filling out the form, it needs to be submitted to the appropriate school official for verification. This process helps maintain eligibility for benefits and ensures that students are receiving the support they need.

Enter the addressee name in the designated field.
Fill in the addressee care of information if applicable.
Provide the addressee PO Box or street address.
Input the addressee city, state, and ZIP code.
Write the case name in the appropriate space.
Enter the case number.
Fill in the date.
Specify the DHS office.
Write the name of the specialist and their ID number.
Provide the specialist's phone number and fax number.
Input the individual ID number.
Fill out the student's name and birthdate.
Complete the date when the form is being filled out.
Sign the client instructions and release of information section.
Take or mail the form to the school.
Ensure the school official completes their section on the back of the form.
Make sure the school official provides their signature, title, phone number, and date.

Dos and Don'ts

When filling out the Michigan Verification Student form, it’s essential to approach the task with care. To help ensure a smooth process, here are six things you should and shouldn't do.

Do ensure that all sections of the form are filled out completely. Missing information can lead to delays or denials.
Don't use abbreviations or shorthand when entering names or addresses. Clarity is key to avoiding confusion.
Do double-check the enrollment status of the student before submitting the form. Accurate details are crucial for verification.
Don't forget to include the student’s signature where required. This step is vital for authorization.
Do provide a valid contact number for the school official completing the form. This allows for quick follow-up if needed.
Don't neglect to submit the form by the specified deadline. Timeliness is essential to prevent any interruption in benefits.

By following these guidelines, you can help ensure that the verification process is efficient and successful.