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2021–2022 Verification of Non-Filing Worksheet
You indicated on your FAFSA that you or someone in your family (if dependent) was not required to file 2019 taxes. As part of
the verification process, the non-tax filer(s) is required to confirm via the IRS that no taxes were filed. The IRS provides a
letter called the Verification of Non-filing that must be submitted to our office. Your parent or spouse must complete and sign
this worksheet, attach any required documents, and submit to the Office of Financial Aid. UA Rich Mountain may ask for
additional information. If you have questions about verification, contact a financial aid administrator as soon as possible so that
your financial aid will not be delayed.
A. Personal Information:
Last Name First Name M.I. SS or ID Number
Street Address (include apt. no.) Date of Birth
City State Zip Code Email Address
Cell Phone Number (include area code) Alternate or Home Phone Number
B. Income Information to Be Verified
Important Note: When a parent of a dependent student or the spouse of an independent student living in the U.S. does not
have a Social Security Number (SSN), an individual Taxpayer Identification Number (ITIN), or an Employer Identification
Number (EIN), he/she is unable to obtain a Verification of Nonfiling Letter from the IRS.
Please check all that apply.
• I certify that I do not have a Social Security Number
• I certify that I do not have an Individual Taxpayer Identification Number (ITIN)
• I certify that I do not have an Employer Identification Number (EIN)
For Employed Non-tax filers only. List every employer even if they did not issue an IRS W-2 form.
Suzy’s Auto Body Shop (example)
C. Certification and Signatures
*Signing this worksheet certifies that all of the information reported is complete and correct.
WARNING: If you purposely give false or misleading
information on this worksheet, you may be fined, be
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sentenced to jail, or both.
________________________ Signature Date
click to sign
signature
click to edit
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