Office of Financial Aid
710 Colegate Drive, Marietta, OH 45750
Phone: 740.568.1908 Fax: 740.376.0257
2020-2021 Dependent Student Non-Filer Form
Student Name: ___________________________________ WSCC ID: _______________ DOB: _____/_____/________
1. Complete and sign this form if you (the student) have not, will not, and are not required to complete a 2018
federal tax return. An incomplete form will be returned to you, which will delay your financial aid.
2. If you (the student) worked in 2018, please submit all 2018 W-2 forms or other earnings statements (i.e.; 1099-
MISC for all employers listed).
3. The Financial Aid Office cannot advise if you are required to file taxes. Please contact a trusted tax preparer or
tax professional to determine if you are required to file taxes.
4. Send this completed form with all other requested items to the address, fax or email address above.
I was not employed and had no income earned from work in 2018.
I was employed in 2018 and have listed below the names of all employers and the amount earned from each.
Please submit all of your 2018 W-2s and other earnings statements with this form.
SIGNATURE STATEMENT - By signing this form, I certify that all information reported is complete, true and correct.
Student Signature: __________________________________________________ Date: _____________________
Office Use Only: Student W2’s Needed? YES______ No______ Student W2’s Received? YES______ No______
Student 2018 Employer(s) Name:
W-2’s Provided?
Student 2018 Earnings List Amount Earned:
WARNING: If you purposely give false or
misleading information, you may be fined,
sent to prison, or both.
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