Revised 11/24/2020
LBWCC - ID
Did you or any one in your household receive any of the following for 2019 or 2020: food stamps? _____
Subsidized Housing? _____ if yes, how much $___________ Subsidized utilities? If yes, how much $__________
Rental Allowance? _____, if yes, how much $___________; Medicaid? ________
Do you receive support not reported on the FAFSA such as food, clothing, or shelter from friends, relatives, a church, etc?
NOTE: Any cash provided to you or cash paid on your behalf must be reported on the FAFSA as untaxed income
.
According to 2019 IRS Publication 17, (go to www.irs.gov - Publication 17, pages 6-7 for more information):
For Dependent Student: Single dependents – must file if any of the following apply (Table 1-2):
• Your unearned income was more than $2,650 ($4,250 if 65 or older and blind).
• Your earned income was more than $13,600 ($15,200 if 65 or older and blind).
• Your gross income was more than the larger of: $2,650 or Your earned income (up to $11,650) plus $1,950.
According to 2019 IRS Publication 17, (go to www.irs.gov
- Publication 17, Table 1-1 for more information):
2019 Filing Requirements for Most Taxpayers: (Parents)
IF your filing Status is AND at the end of 2018 you were…
THEN file a return if your income
was at least...
Married filing jointly
65 or older (both spouses)
Married filing separately
Qualifying widow(er) with dependent
child
By signing this worksheet, I (we) certify that all the information reported to qualify for student aid is complete
and correct and that I (we) was (were) not required to file a 2019 Federal Income Tax Return. At least one
parent must sign.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or
both.
_______________________________________ _______________________________________
Student Date Parent Date
It is the official policy of the Alabama Department of Postsecondary Education, including postsecondary institutions under the control of the State Board of Education, that no
person shall, on the grounds of race, color, handicap, gender, religion, creed, national origin, or age, be excluded from participation in, be denied the benefits of, or be subjected
to discrimination under any program, activity or employment. LBW Community College will make reasonable accommodations for qualified disabled applicants or employees
.
You must provide a statement from the IRS stating that a 2019 Federal Tax Return was not filed for you
and your parent(s).
