OFFICE OF FINANCIAL AID
4525 Education Park Drive, Schnecksville, PA 18078
P 610.799.1133| F 610.799.1798
E finaid@mymail.lccc.edu
2019-20 Verification of Tax Return Non-filing status
Dependent Student
Student Name ID#
S
tudent: Check the box(es) that applies:
I did not earn income in 2017 and I am not required to file a 2017 Tax Return.
I did earn income in 2017 but am not required to file a 2017 Tax Return. Attached are my 2017 W-2s
Source of Income (Employer’s Name)
(fill out only if you did NOT file federal taxes in 2017)
Parent(s): Check the box(es) that applies:
I did not earn income in 2017 and I am not required to file a 2017 Tax Return.
I have not attempted to obtain a Verification of Non-filing from the IRS. You cannot submit this form until
you have first attempted to obtain a Verification of Non-filing from the IRS.
I attempted to obtain a Verification of Non-filing from the IRS and was unable to obtain the required
documentation via the following method: (check one)
Using the ‘Get Transcript Online’ feature at
31TUwww.irs.gov/individuals/get-transcriptU31T
Submit IRS Form 4506-T via mail or fax
Visited a local IRS Office
I did earn income in 2017 but am not required to file a 2017 Tax Return. Attached are my 2017 W-2s
Source of Income (Employer’s Name)
(fill out only if you did NOT file federal taxes in 2017)
Certifications and Signatures
Each person signing below certifies that all of the
information reported is complete and correct.
U___U U______________________________________________
Print Student’s Name Student’s ID Number
__
_______________________________________________________________________________________________
Student’s Signature (Required) Date
__
_______________________________________________________________________________________________
Parent’s Signature (Required) Date
WARNING: If you purposely give false or misleading
information you may be fined, be sentenced to jail or
