Fillable B. Parent(s) 2019 IRS Income Tax Return Filing (Virginia Western Community College)

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B. Parent(s) 2019 IRS Income Tax Return Filing (Virginia Western Community College)

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The B. Parent(s) 2019 IRS Income Tax Return Filing (Virginia Western Community College) form is 2 pages long and contains:

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  • 6 check-boxes
  • 48 other fields

Country of origin: US
File type: PDF

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U2021-2022 Parent Verification of Non-Filing Status for Tax Year 2019U
The U.S. Department of Education selected your student’s 2021-2022 FAFSA for verification. You and your spouse, if you
are married, must complete this form. One parent and the student must sign and submit this form to the Financial Aid Office.
If additional space is needed attach a sheet with the required information, and include your student’s Name and VWCC ID
at the top of the page. Instructions for submission are at the bottom of the form.
A. Student Information
First Name MI
Last Name
VWCC Student ID - REQUIRED
B. Parent(s) 2019 IRS Income Tax Return Filing Status
Select UONEU option from the three provided below for parent one and parent two. UIf you are single, divorced, or never marriedU Uand
not living with your student’s other biological parent, only enter information in the Parent One section of this form.U
PARENT ONE NAME:
First Name MI Last Name
I earned income in 2019 but did not file, nor was I required to file, an income tax return. I have listed my sources of
income and amounts below.
Income Source/Employer Name
Amount Earned in
2019
Example: Dan’s Autobody
$2500.00
I have been granted a 2019 income tax filing extension beyond the standard six months extension. As required:
•
I have attached an approved copy of the extension granted by the U.S. Internal Revenue Service
(IRS);
• I have listed my sources of income in the box below;U andU
• If I am self-employed, I have attached a signed statement estimating my 2019 AGI and taxes paid.
Income Source/Employer Name
Amount Earned in
2019
Example: Dan’s Autobody
$2500.00
I was not employed in 2019 and earned no income from work.
2021-2022 Forms
Student First Name MI Student Last Name VWCC Student ID
PARENT TWO NAME:
First Name MI Last Name
I earned income in 2019 but did not file, nor was I required to file, an income tax return. I have listed my sources of
income and amounts below.
Income Source/Employer Name
Amount Earned in
2019
Example: Dan’s Autobody
$2500.00
I have been granted a 2019 income tax filing extension beyond the standard six months extension. As required:
•
I have attached an approved copy of the extension granted by the U.S. Internal Revenue Service
(IRS);
• I have listed my sources of income in the box below;U andU
• If I am self-employed, I have attached a signed statement estimating my 2019 AGI and taxes paid.
Income Source/Employer Name
Amount Earned in
2019
Example: Dan’s Autobody
$2500.00
C. Certification and Signatures
Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any
additional information is attached. The student and one parent MUST sign and date this section.
WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced
to jail, or both.
______________________________________________________________________
Student Signature Required
______________________________________________________________________
Parent Signature Required
WAYS TO SUBMIT THIS FORM
1) Upload the form at Uwww.virginiawestern.comU by clicking ‘Contact Us,’ and then clicking the 24/7
Student Support icon. Once you log in you can submit documents (2) Fax forms to 540-857-
6208♦Phone: (855)874-6690 (Revised 10/2020)
2021-2022 Forms
I was not employed in 2019 and earned no income from work.
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B. Parent(s) 2019 IRS Income Tax Return Filing (Virginia Western Community College)

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Completed 4 February 2021

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