Office of Financial Aid
323 Erie Street, P.O. Box 5015, Port Huron, Michigan 48061-5015
810-989-5530 fax 810-989-5774 sc4.edu
4/9/2020
2020-21 Verification of Non-filing Statement
Student Name ________________________________________ Student ID # _________________________
You, and/or your spouse or parent(s) indicated on your 2020-2021 FAFSA that you, and/or your
spouse or parent(s) did not file a 2018 federal income tax return with the IRS. Due to this response
please complete the following as verification of non-filing.
Section 1: Please read and sign for the statement below.
“I, the student and/or my spouse (if applicable), or my parent(s) (if applicable) have attempted
to obtain the Verification of Non-Filing from the IRS and have been unsuccessful in doing so.”
Student’s Signature _________________________________________________ Date _________________
Parent’s Signature __________________________________________________ Date _________________
(for dependent’s only)
Section 2:
A. Dependent: (Complete this section if you are considered a dependent student and parent’s
information is being verified)
The parent(s) was not employed and had no income earned from work in 2018 and has not
filed a Federal Income Tax Return (or foreign equivalent) and is not required to do so.
The parent(s) was employed in 2018, but has not filed a Federal Income Tax Return (or
foreign equivalent) and is not required to do so. I have attached copies of all 2018 w-2’s or a
Wage and Income Statement from the IRS.
*List below all sources of income for 2018 for parent(s); attach documentation as applicable. If no
income, write “none.”
B. Independent: (Complete this section if you are considered an independent student and
your/spouse information is being verified)
I, the student and/or my spouse (if applicable), was not employed and had no income earned
from work in 2018 and have not filed a Federal Income Tax Return (or foreign equivalent) and
am not required to do so.
I, the student and/or my spouse (if applicable), was employed in 2018, but have not filed a
Federal Income Tax Return (or foreign equivalent) and am not required to do so. I have
attached copies of all 2018 w-2’s or a Wage and Income Statement from the IRS.
Source of income
Dollar amount
Academic credits earned
$
Yes No
$
Yes No
Student ID:_______________
Rec’d by:_________________
Date:____________________
Office of Financial Aid
323 Erie Street, P.O. Box 5015, Port Huron, Michigan 48061-5015
810-989-5530 fax 810-989-5774 sc4.edu
4/9/2020
Student’s Signature _________________________________________________ Date _________________
If you are able, please print and physically sign this form. If you do not have access to
print, please type your name above, but you will need to come into the Financial Aid
office once we re-open to sign.
Submit this worksheet to the Financial Aid Office at SC4.
St. Clair County Community College
financialaid@sc4.edu
Source of income
Dollar amount
Academic credits earned
$
Yes No
$
Yes No
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