Office of Student Financial Aid
Phone: (240)567-5100
Email: FinancialAid@montgomerycollege.edu
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2019-2020 Student Non-Filing Verification Statement
STUDENT INFORMATION
Student Name:
MC ID#:
You indicated on your FAFSA that you did not and were not required to file a 2017 tax return.
PLEASE COMPLETE ALL SECTIONS OF THIS FORM BEFORE SUBMITTING IT WITH ALL OTHER REQUESTED DOCUMENTS TOGETHER.
2017 FEDERAL INCOME TAX FILING REQUIREMENTS
The following chart refers to U.S. tax filing requirements. For most people, a U.S. tax return must be filed with the Internal
Revenue Service (IRS) if their 2017 income was at least:
Numbers provided as
available, from irs.gov.
Amounts for
people under the
age of 65; if you
are over 65, visit
irs.gov.
Single dependent student
(your parents or someone else
can claim you as a dependent)
$6,350 (earned
income)
Married, filing separately
$4,050 (gross
income)
Single, if claiming self
$10,400 (gross
income)
Head of household
$13,400 (gross
income)
Married, filing joint return
$20,800 (gross
income)
Qualifying widow(er)
with dependent child
$16,750 (gross
income)
STUDENT’S MARITAL STATUS
Unmarried, Separated, or Widowed
Married/Remarried
Married but spouse lives outside of the U.S.
STUDENT’S NON-FILING INFORMATION
I did not and was not required to file a 2017 federal tax return or file or pay taxes in a foreign country because I had no
income from work.
I was not required to file a 2017 federal tax return because all income earned from work was below the IRS filing
requirement. In the space below, please list all employers and the amount earned.
Employer’s Name (If more space is needed, attach an additional sheet)
Annual Income Earned
$
$
$
CONTINUED ON NEXT PAGE
I was not required to file a 2017 federal tax return because all income was earned in a foreign country. The Financial Aid
Office may request documentation from the foreign employer to verify the amount of income earned.
Employer’s Name (If more space is needed, attach an additional sheet)
Annual Amount (Convert to US Dollars)
$
$
M
Office use only
Code: SNONFE / FA NON FILING STU EVEN
I / We certify that all the information contained on this form is complete and correct. NOTE: If you purposely give false
or
misleading information, you may be imprisoned and/or fined up to $25,000. I / We
understand that this form must be
signed and submitted with all other requested documents before my financial aid will be processed.
Electronic
signatures
are not accepted.
Student Signature (must be in dark ink)
Date
Spouse Signature (If necessary)
Date
The OSFA may request additional documentation based on the information provided on this form. If it is determined that a 2016
tax return should have been filed with the IRS, your financial aid cannot be processed until an official tax transcript is submitted to
the Office of Student Financial Aid. You will be notified through Montgomery College email if any additional information is
required.
NEXT STEPS:
CERTIFICATION
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M
2019-2020 Student Non-Filing Verification Statement
Page 2
SPOUSE’S NON-FILING INFORMATION
My spouse did not and was not required to file a 2017 federal tax return or file or pay taxes in a foreign country because he
or she had no income from work.
My spouse was not required to file a 2017 federal tax return because all income earned from work was below the IRS filing
requirement. In the space below, please list all employers and the amount earned.
Employer’s Name (If more space is needed, attach an additional sheet)
Annual Income Earned
$
$
$
My spouse was not required to file a 2017 federal tax return because all income was earned in a foreign country. The
Financial Aid Office may request documentation from the foreign employer to verify the amount of income earned.
Employer’s Name (If more space is needed, attach an additional sheet)
Annual Amount (Convert to US Dollars)
$
$