Fillable 1819 Nonfiler Student Student (Hope College)

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1819 Nonfiler Student Student (Hope College)

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NOTAXS
Non-Tax Filer Statement - Student
2018-2019
Office of Financial Aid ▪ 100 East 8
th
Street ▪ PO Box 9000 ▪ Holland, MI 49422-9000
P: 616-395-7765 ▪ F: 616-395-7160 ▪ finaid@hope.edu ▪ hope.edu/financialaid
Complete and return this form only if you did not and will not file a 2016 Federal Income Tax Return.
Student Name:
Hope College ID Number:
1. Submit copies of all W-2 forms received for 2016.
2. CERTIFICATION:
I have not filed and am not required to file a 2016 federal income tax return.
Listed below is my 2016 earnings from employment and/or untaxed income.
Enter "none" or "0" if you had no income.
TOTAL 2016 INCOME EARNED FROM WORK AND/OR UNTAXED INCOME
AMOUNT EMPLOYER OR SOURCE
IRS W-2
PROVIDED?
$
$
$
$_______________
TOTAL
Examples of Income Earned from Work:
Income earned from employment (which includes
any income reported on 2016 W-2 Forms) plus any other earnings from employment not reported
on W-2 Forms.
Examples of Other TAXABLE Income to be reported above: Interest/dividend income,
alimony received, business/farm income, capital gains, pensions, annuities, rents, unemployment
compensation, taxable Social Security benefits, Railroad Retirement benefits, etc.
Examples of UNTAXED Income: Untaxed Social Security benefits, Aid to Families with
Dependent Children (AFDC/ADC or TANF), child support received for ALL your dependent
children, other welfare benefits, workers' compensation, cash, or any money paid on your behalf,
etc.
WARNING: If you purposely give false or misleading information, you may be fined, sent
to prison, or both.
My signature below certifies that all of the information reported is complete and correct.
Student Signature:
Date Signed:
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1819 Nonfiler Student Student (Hope College)

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Completed 23 July 2020

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