______________________________________ __________________
______
___
_____________________________ __________________
2020-2021
LOW INCOME STATEMENT/with UNTAXABLE INCOME
I will not file a 2018 IRS form 1040/1040A or 1040EZ. I did not receive
any taxable income during 2018.
I certify that all the financial aid information reported on my 2020-2021
FAFSA/ Student Aid Report is true and complete to the best of my
knowledge.
I have requested a 4506-T letter/transcript and/or verification from the IRS
verifying my non-filing status. As soon as I receive this verification, it will
be submitted to the J Sargeant Reynolds Financial Aid office.
St
udent
Signature
Date
Spouse’s
Signat
ure Date
Pl
ease
note:
Further
documentation
may be
required,
i.e.
proof
of se
parate
domiciles;
order
of c
hild
support
and/or
spousal
support,
etc.
As pe
r
the
United
States De
partment
of E
ducation, “
If y
ou pur
posely
give
false
or
misleading i
nformation,
you m
ay be
fined
$20,000, se
nt
to
prison,
or
both.”
07/03/18
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