2020 – 2021 Student Non-Tax Filer’s Statement
Office of Financial Aid
This form should be completed if you or your spouse did not file a 2018 U.S. federal tax return. Student Name: _____________________________________________________________ Student ID#:_______________________
NON-TAX FILER INFORMATION (PLEASE PRINT CLEARLY): Non-Tax Filer completing this form: [ ] Student
[ ] Spouse
[ ] Both Student and Spouse
Spouse’s Name: ___________________________
_________________________
List all sources of income and dollar amounts received from January 1, 2018 to December 31, 2018. SOURCE OF INCOME (Such as: work, worker’s comp, SSI, child support, family or friends, etc.)
EXAMPLE: ABC Corporation
AMOUNT EARNED IN 2018 5,000
INDICATE STUDENT OR SPOUSE Student
Provide a copy of W-2’s, 1099’s, etc. for each source of income listed above. BENEFITS RECEIVED IN 2018: • Public Assistance? • Social Security Insurance? • SNAP (Food Stamps)?
YES ___ ___ ___
NO ___ ___ ___
By signing this form, I certify that: ➢ I have attempted to obtain verification of non-filing from the IRS and was unable to obtain it (not required for dependent students) ➢ I have not filed and was not required to file a 2018 tax return. ➢ Confirm the above information is complete and correct. Student Signature ______________ Spouse Signature ________
_____
Date Date
(if applicable)
FACNFP20
SUBMIT THIS FORM TO YOUR OFFICE OF FINANCIAL AID