2019-2020 Verification of 2017 Income Information for Parent Nontax Filers
Please return this completed form to Indian Hills Community College along with any other requested materials:
Fax: 641.683.5741│ Mail: IHCC Financial Aid Office, 525 Grandview Ave, Ottumwa, IA 52501
or bring to One Stop/Bennett Student Services Building
You can check your financial aid document status, print required forms, and view your financial aid award information (once available) on WebAdvisor.
The instructions and certifications below apply to each parent included in the household. Complete this section
if the parents will not file and are not required
to file a 2017 income tax return with the IRS.
Check the box that applies:
Neither parent was employed, and neither had income earned from work in 2017.
One or both parents were employed in 2017 and have listed below the names of all employers, the
amount earned from each employer in 2017, and whether an IRS W-2 form or an equivalent document is
provided. [Provide copies of all 2017 IRS W-2 forms issued to the parents by their employers]. 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 the student’s name and ID number at the top.
Earned in 2017
(Example) ABC’s Auto Body Shop
Submit an IRS Verification of Nonfiling Letter. You can order a Verification of Nonfiling Letter on the IRS Web site or
by submitting Form 4506-T to the IRS and checking box 7. Specify which tax year(s) you need, and mail or fax the
completed form to the IRS at the address or fax number provided in the instructions.
____ Check here if confirmation of nonfiling is provided.
____ Check here if confirmation of nonfiling will be provided later.
Certifications and Signatures
Each person signing below certifies that all of the
information reported is complete and correct.
The student and one parent whose information was
reported on the FAFSA must sign and date.
A hand written signature, not typed, is required.
Student’s Signature (Required) Date
Parent’s Signature (Required) Date
WARNING: If you purposely give false or
misleading information, you may be
fined, sent to prison, or both.