2018-2019 Verification of 2016 Income Information for Spousal Nontax Filers
Student Name:
GTCC ID:
The instructions and certifications below apply you and your spouse, if married. Complete this section if
you and your spouse will not file and are not required to file a 2016 income tax return with the IRS.
Check the box that applies:
☐ My spouse was not employed and had no income earned from work in 2016 (if married).
☐ My spouse was employed in 2016 and I have listed below the names of all employers, the amount
earned from each employer in 2016, and whether an IRS W-2 form is provided. Provide copies of all
2016 IRS W-2 forms issued to you and your spouse by your employers. A copy of the 2016 IRS
Wage and Income Transcript may also be provided in lieu of individual 2016 IRS W-2 forms. List
every employer even if the employer did not issue an IRS W-2 form.
If more space is needed, provide a separate page with your name and ID number at the top.
2016 Amount
Earned
Must attach copies
of ALL
W-2’s to this form
Suzy’s Auto Body Shop (example)
Note: We may require you to provide documentation from the IRS that indicates a 2016 IRS income tax
return was not filed with the IRS.
To obtain a 2016 IRS Wage and Income Transcript, go to www.IRS.gov and click on the “Get Transcript
for My Tax Records” link. Select the option to “Get Transcript Online.” Then you can download and print
the Wage and Income Transcript immediately.
Student’s Signature Date
Please return this completed form to: GTCC Financial Aid Office, PO Box 309, Jamestown, NC
27282 or FAX to 336-217-8468.
Financial Aid Office P.O. Box 309 Jamestown, NC 27282
Phone: 336.334.4822 Option 3 Fax: 336.217.8468
Certification and Signatures
Signing this worksheet certifies that all of the information you reported on it is
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to jail, or both.
Phone:
click to sign
signature
click to edit
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