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FAC18FID (Howard Community College)

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BROWSE HOWARD COMMUNITY COLLEGE FORMS

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Student’s Last Name Student’s First Name HCC ID Number
2018/2019 Dependent Foreign Income Supplement
A. Complete this section if student and/or parent(s) earned no foreign income in 2016.
 Student earned no income from work in 2016. No further documentation needed.
Parent(s) earned no income from work in 2016 AND
• parent(s)haveattachedstatementofnonlingfromrelevanttaxauthority(datedonorafterOct.1,2017).
Parent(s) earned no income from work in 2016 BUT
• parent(s) cannot provide statement of nonling.Pleasecompletethefollowingstatement:
 I/We cannotobtainastatementofnonlingfromatax
Parent(s)’ name or names
authorityin anddeclarethatI/wehadnoincomeearnedfromworkin2016.
Nameofcountry
PLEASE READ: If parent(s) earned no income in 2016, please explain how the parent(s)
supported their household in 2016. Use the space in Section E on page 2.
B. Complete this section if student and/or parent(s) earned income in a foreign country in 2016.
I/we have 2016 income from
Name or names of earners
Nameofcountryandcurrency
andarerequiredtoletaxes. Attachforeigntaxtranscript*ifforeigntaxauthority does not charge a fee for
transcript. Ifforeigntaxauthority does charge a fee for transcript,attachsignedcopyofforeigntaxreturn*,along
with documentationstatingthattaxauthoritychargesafee.Then, skip to section F.
I/we have 2016 income from
Name or names of earners
Nameofcountryandcurrency
and are NOT requiredtoletaxes.
Complete section C (student) or D (parents), below, for non-tax lers with income.
* If transcript or tax return is not in English, student should provide translation containing amount of gross income earned and
income taxes paid in country’s currency and in US dollars.
C. Student’s 2016 Foreign Income Foreign Currency
1.Enteramountofforeignincomeyouearnedin2016
x
ExchangeRate
= $
U.S.Dollars
2.EntertheamountofanyincomeyouearnedintheU.S.in2016
$
Total Income (Dollars):
$
Student’sIncomeTax:
EntertheamountofincometaxpaidtogovernmentsotherthanU.S.
x
ExchangeRate U.S.Dollars
D. Parent(s)’ 2016 Foreign Income Foreign Currency
1.Enteramountparent(s)earnedfromemploymentbyothers.
2.Entertheamountofincomefromowningoroperatingabusiness
3.Entertheamountofretirementpensionincomefromemployers.
4.Entertheamountofincomeparent(s)receivedfromfarming.
Total Foreign Income converted to US Dollars: x
ExchangeRate
= $
U.S.Dollars
5. Enter the amount ofanyincomeearned in the U.S. in 2016. $
Total Income (Dollars):
$
Parent(s)’IncomeTax:
EntertheamountofincometaxpaidtogovernmentsotherthanU.S.
x
ExchangeRate
= $
U.S.Dollars
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Financial Aid Services
10901LittlePatuxentPkwy
ColumbiaMD21044
443-518-1260;443-518-4576(FAX)
naid@howardcc.edu;www.howardcc.edu
CRI: FAC18FID
ImageNow:
Doctype:UGVerication
FADocName:V-Vericationforms
Work Flow:
Main:FASDocumentProcessing
Sub-queue:AcademicYear
F. Certication and Signature
Eachpersonsigningbelowcertiesthatalloftheinformationreportediscompleteandcorrect.
WARNING:Ifyoupurposelygivefalseormisleadinginformation,youmaybened,senttoprison,orboth.
ParentSignatureDate
StudentSignatureDate
E. If parent(s) earned no income in 2016, please explain how the parent(s) supported their family in 2016.
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FAC18FID (Howard Community College)

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Completed 22 July 2020

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