Financial Aid Office
2019 2020 Nontax Filer Worksheet for Parents
___________________________ ________________________
Student Name
________________________________
Student ID #
Phone Number
The instructions and certifications below apply to each parent included in the household. Complete this section
if the parents will not file and are not required to file a 2017 income tax return with the IRS.
Check the box that applies:
Neither parent was employed, and neither had income earned from work in 2017.
One or both parents were employed in 2017 and have listed below the names of all employers, the amount
earned from each employer in 2017, and whether an IRS W-2 form is provided. [Provide copies of all 2017
IRS W-2 forms issued to the parents by their employers]. List every employer even if the employer did not
issue an IRS W-2 form.
You MUST provide copies of all 2017 IRS W-2 forms issued to you by your employers. A copy of the 2017
IRS Wage and Income Transcript may also be provided in lieu of individual 2017 IRS W-2 forms.
Employer’s Name
IRS W-2
Provided?
Amount
Earned in 2017
(Example) ABC’s Auto Body Shop
Yes
$4,500.00
Total Amount of Income Earned From Work
$
Provide Verification of Non-filing documentation from the IRS dated on or after October 1, 2018 that
indicates a 2017 IRS income tax return was not filed with the IRS or other relevant tax authority. You can
request this using Form 4506-T.
Certification and Signature
Each person signing below certifies that all of the information reported is complete and correct. Warning: If you
purposely give false or misleading information you may be fined, be sentenced to jail, or both.
______________________________________________ ____________________________________
Student’s Signature Date
______________________________________________ ____________________________________
Parent’s Signature Date
Please return this completed form to:
Caldwell Campus
2855 Hickory Blvd.
Hudson, NC 28638
Fax: 828.726.2709
Email: finaid@cccti.edu
Watauga Campus
P.O. Box 3318
Boone, NC 28607
Fax: 828.297.1729
Email: finaid@cccti.edu
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