Fillable 2020-2021 Verification of Non-Filing Status (4506-T) (California State University, San Bernardino)

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2020-2021 Verification of Non-Filing Status (4506-T) (California State University, San Bernardino)

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The 2020-2021 Verification of Non-Filing Status (4506-T) (California State University, San Bernardino) form is 1 page long and contains:

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  • 5 check-boxes
  • 12 other fields

Country of origin: US
File type: PDF

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2020-2021 Verification of Non-Filing Status
Student Name:
Coyote ID:
Phone Number:
I, _____________________________, have attempted to obtain a Verification of Non-Filing form
(4506-T) from the Internal Revenue Service (IRS) for the 2018 tax year, but have been
unsuccessful. I certify that I have not and am not required to file a 2018 Tax Return per the IRS
Filing Requirements. Please attach any W-2s and/or 1099 forms received for 2018.
Relationship to Student:
Spouse
Parent
Please check the box that applies to you:
I was not employed and did not earn any income in 2018.
I was employed but did not receive W-2’s and/or 1099 forms for 2018. Listed below are the
source(s) and the amounts of income that I earned in the 2018.
2018 Source of Income Earned:
Source of Income Amount
$
$
$
By signing this document, I certify that the information reported and any attachments
submitted hereto are true, complete, and accurate. In addition, I certify that I have
unsuccessfully attempted to obtain a Verification of Non-Filing Form from IRS.
Student Signature: __________________________________ Date: __________________
Parent/Spouse Signature:________________________________ Date: __________________
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2020-2021 Verification of Non-Filing Status (4506-T) (California State University, San Bernardino)

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Completed 12 August 2020

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