Office of Financial Aid
Hepburn Hall, Room 215
2039 John F. Kennedy Boulevard | Jersey City, NJ 07305
Phone: (201) 200-3173| Fax: (201) 200-3181 | Email:
Please log into your Gothic
Portal and upload form to
2019-2020 Non Filing Statement for Parent of Dependent Student
_____________________________________ ______________________
Your application was selected for review in a process called “Verification”. In this process, the Financial
Aid Office will be comparing information from your FAFSA application with your parent(s) 2017 W-2
forms and any other requested financial documents. Only the parent(s) must complete this form.
If your parent(s) worked but did not file taxes, the following requirements must be submitted:
a) Copies of your parents’ 2017 W2
b) Complete and sign this form Parent must sign this form.
Parent(s) Income
Please check one of the following:
______ I have attached my W-2’s to this form as proof of my income.
______ I did not received a W-2.
______ I did not work.
List the source of your employment and the amount earned through that employment.
Source Amount
_______________________________________ __________________________________
_______________________________________ __________________________________
_______________________________________ __________________________________
_______________________________________ __________________________________
_______________________________________ __________________________________
I attempted and was unable to obtain a Verification of Non Filing Letter from the IRS or other tax
authorities and have not nor am I required to file a 2017 Federal Income Tax Return.
The student whose information was reported on the FAFSA must sign and date.
____________________________________________ _________________________
Student Signature Date
____________________________________________ __________________________
Parent Signature Date