2020-2021 Student Income Verification
20SIVER
To request a copy of a *Federal IRS Tax Return Transcript, Wage Statement, OR Verification of Non-Filing Letter
call the IRS at 1-800-908-9946, go to http://www.irs.gov/individuals/Order-a-Transcript
2018 Income Information for Tax FilersCheck the box that applies
Student/Spouse (if married)
Documentation Required
I/we filed a 2018 Federal Tax Return
Attach a copy of student/spouse (if married) 2018 IRS Tax Return Transcript*
Student married/remarried after the 2018 tax year
Attach a copy of the 2018 IRS Tax Return Transcript* for the one who FILED and complete
the Non-Tax Filers section below for the one who did not file a tax return
I/we filed an amended 2018 IRS tax return
Attach a copy of both a 2018 IRS Tax Return Transcript* and a signed copy of the 2018 IRS
Form 1040X “Amended US Individual Tax Return” that was filed with the IRS
2018 Income Information for Non-Tax FilersCheck the box that applies
Student/Spouse (if married)
Documentation Required
Student and/or spouse (if married) were employed in
2018 but not required to file a tax return. (Complete
the chart below)
Attach copies of all W-2s* and a 2018 IRS Verification of Non-filing* status letter dated on
or after October 1, 2019 for non-filer(s). Note: If you are a Dependent student, the IRS
Verification of Non-filing is NOT required.
Neither student and spouse (if married) were employed
and neither had income earned from work in 2018
Attach a 2018 IRS Verification of Non-filing* status letter dated on or after October 1, 2019
for non-filer(s). Note: If you are a Dependent student, this document is NOT required.
Employer’s Name
2018 Amount Earned
IRS W-2 Attached?
Susy’s Auto Body Shop (example)
$2000.00
Yes
$
$
$
Student/spouse (if married) received the following benefits in 2018 as part of their financial support:
Supplemental Security Income (SSI) Social Security Benefits
TANF
Other ________________________________________________
Asset Information
Complete this chart about the student/spouse (if married) asset information as of the date you signed the FAFSA or CA Dream Act Application.
1. Cash/checking/saving balances as of the date you signed the FAFSA or CA Dream Act Application $
2. Investment value (rental real estate, stocks) as of the date you signed the FAFSA or CA Dream Act Application $
3. Business Value as of the date you signed the FAFSA or CA Dream Act Application $
CERTIFICATION
I
/WE HEREBY CERTIFY THAT ALL INFORMATION REPORTED ON THIS FORM AND ANY ATTACHMENTS HERETO ARE TRUE, COMPLETE AND ACCURATE.
FALSE INFORMATION OR MISREPRESENTATION WILL BE CAUSE FOR DENIAL, REDUCTION, WITHDRAWAL, AND/OR REPAYMENT OF FINANCIAL AID.
________________________________________________________________ __________________________
Student’s Signature Date
________________________________________________________________ __________________________
Spouse’s Signature (Optional) Date
2020
-2021 STUDENT INCOME VERIFICATION
STUDENT INFORMATION
Last Name
First Name
M.I
Student ID Number
Mt. San Jacinto College Financial Aid Office
Website: https://msjc.edu/financialaid/
Virtual Lobby: https://msjc.edu/hub/
Telephone: (951) 487-3245
Email: Finaid@msjc.edu
P R I N T
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C L E A R
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