2018-2019
Statement of Inability to Obtain
IRS Tax-Related Documents
Office of Student Financial Aid
1021 Dulaney Valley Road
Baltimore, Maryland 21204-2794
P: 410-337-6141
F: 410-337-6504
E: finaid@goucher.edu
________________________________ _____________________ _____________________
Student Last Name Student First Name Goucher ID Number
This signed statement is required from an individual when documentation of nonfiling is needed for a
student’s financial aid application, but they are unable to obtain documentation from the IRS.
Individual making this statement:
_______________________________________________ _______________________________
Last Name First Name
Relationship to Student:
☐ Self ☐ Parent ☐ Spouse ☐ Other: _______________________
Signed Statement
I CERTIFY ALL OF THE FOLLOWING:
All of the information provided and any supporting documentation submitted is complete, true, and
accurate.
I am unable to obtain tax documents from the IRS.
I have not filed and was not required to file a 2016 income tax return.
I will provide (or have already provided) the sources and amounts of earnings, other income, and
resources that have supported me in 2016.
I will provide (or have already provided) any available W2 forms for each source of employment
income in 2016.
_____________________________________________ _____________________________
Signature Date
(ELECTRONIC SIGNATURES NOT ACCEPTED. Please print & sign in ink, then mail, fax, or scan and e-mail.)
