Room U-201
P: 718.368.4644
F: 718.368.4656
finaid@kbcc.cuny.edu
Kingsborough Community College
Of The City University of New York
2001 Oriental Boulevard
Brooklyn, New York 11235
2019-2020 NON-FILER CONFIRMATION STATEMENT
for students, parents or spouses who are unable to obtain IRS Verification of Non-filing
STUDENT’S NAME: CUNYfirst ID#:
In order to complete verification of your FAFSA information, an IRS Verification of Non-filing Letter dated October 1, 2018, or
later, must be submitted for every non-tax filer whose 2017 income information was required to be reported on your FAFSA.
You have been given this form because you have attempted to obtain a Verification of Non-filing from the IRS or other tax
authority and are unable to obtain the letter.
A separate statement should be submitted for each individual who will not be able to provide an IRS Verification of Non-filing
Letter for the reason mentioned above.
Full Name: ____________________________________ Relationship to student (If applicable):__________________________
I attest that I have attempted to obtain a Verification of Non-filing from the IRS or other tax authority and was
unable to obtain the required document.
I attest that I have not filed and am not required to file a 2017 income tax return.
I worked in 2017. In the income grid below, list all sources of 2017 income earned from work. (A
W2 from each employer must also be provided if income was earned from work in 2017.)
Name of Employer Wages
I did not work in 2017. Please explain what resources supported you:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
I/we hereby certify that all information contained on this form is true and complete to the best of my/our knowledge. I/we have not knowingly
or intentionally provided any false information. I understand that if I am found to have knowingly or intentionally given false statements or
information my eligibility for federal student aid will be at risk.
_______________________________________________ _____________________
Student Signature Date
_____________________________________________ _____________________
Parent Signature Date
_______________________________________________ _____________________
Spouse Signature Date
Verification of Non-Filing Status
