FORM SUTINC - IDAHO STATE UNIVERSITY 19-20
UNTAXED INCOME REQUEST
STUDENT
The federal government requires colleges to check the accuracy of the information you
provided on your Free Application for Federal Student Aid (FAFSA). This process is
called verification. You must complete the verification process before the Office of
Financial Aid can establish your eligibility for assistance. You must return the
information requested on this form or you will not be considered for federal financial
aid. Please return this completed form to:
Office of Financial Aid, Idaho State University, Museum Building, Room 337
921 S 8 Ave, Stop 8077, Pocatello, ID 83209-8077
th
Phone: (208)282-2756 Fax: (208)282-4755 Email: finaidem@isu.edu
Web: https://www.isu.edu/financialaid/forms
SUTINC-20
*Student Name:
(Use blue or black ink) Last First M.I.
*ISU ID: *Last 4 Digits of Social Security #:
(Find under Academic Tools tab on BengalWeb) *Required
INSTRUCTIONS: Provide amounts for each item below from both you and, if married, your
spouse. Do not leave any questions blank; enter a zero (0) if a question does not apply to you.
AMOUNT
Payments to tax-deferred pension and savings plans (paid directly or withheld from earnings)
including but not limited to, amounts reported on the W-2 form in Boxes 12a through 12d, codes D, E,
F, G, H, and S. Don’t include amounts reported in code DD.
$
IRA deductions and payments to self-employed SEP, SIMPLE, Keogh and other qualified plans. $
Child support received for all children. Don’t include foster care or adoption payments.
$
Housing, food, and other living allowances paid to members of the military, clergy, and others
(including cash payments and cash value of benefits). Don’t include value of on-base military
housing or the value of a basic military allowance for housing.
$
Veterans’ non-educational benefits such as Disability, Death Pension, or Dependency & Indemnity
Compensation (DIC), and/or VA Educational Work-Study allowances.
$
Other untaxed income such as workers’ compensation, disability, etc. Don’t include extended foster
care benefits, student aid, earned income credit, additional child tax credit, welfare payments,
untaxed Social Security benefits, Supplemental Security Income, educational W IA benefits, on-base
military housing or a military housing allowance, combat pay, or benefits from flexible spending
arrangements, e.g. cafeteria plans, foreign income exclusion or credit for federal tax on special fuels.
$
Money received, or paid on your behalf (e.g., bills, rent, utilities, car payments) not reported
elsewhere on this form.
$
Total 2017 Sources of Untaxed Income:
$
CERTIFICATION: The person signing below certifies that all of the information reported is complete
and correct.
Student Signature: Date:
WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or both.
(v. 12/13/2018) (S:\20_Forms\formSUTINC.wpd)
Please fill in blanks, print, sign, attach docs & return
Press tab or shift-tab to move between fields
