N
OTAXS
Non-Tax Filer Statement - Student
2020-2021
Office of Financial Aid ▪ 100 East 8
th
Street ▪ PO Box 9000 ▪ Holland, MI 49422-9000
P: 616-395-7765 ▪ F: 616-395-7160 ▪ finaid@hope.edu ▪ hope.edu/financialaid
Complete and return this form only if you did not and will not file a 2018 Federal Income Tax Return.
Student Name: Hope College ID Number:
1. Submit copies of all W-2 forms received for 2018.
2. CERTIFICATION:
I have not filed and am not required to file a 2018 federal income tax return.
Listed below is my 2018 earnings from employment and/or untaxed income.
Enter "none" or "0" if you had no income.
TOTAL 2018 INCOME EARNED FROM WORK AND/OR UNTAXED INCOME
AMOUNT EMPLOYER OR SOURCE
$
$
$
TOTAL
Examples of Income Earned from Work: Income earned from employment (which includes
any income reported on 2018 W-2 Forms) plus any other earnings from employment not reported
on W-2 Forms.
Examples of Other TAXABLE Income to be reported above: Interest/dividend income,
alimony received, business/farm income, capital gains, pensions, annuities, rents, unemployment
compensation, taxable Social Security benefits, Railroad Retirement benefits, etc.
Examples of UNTAXED Income: Untaxed Social Security benefits, Aid to Families with
Dependent Children (AFDC/ADC or TANF), child support received for ALL your dependent
children, other welfare benefits, workers' compensation, cash, or any money paid on your behalf,
etc.
WARNING: If you purposely give false or misleading information, you may be fined, sent
to prison, or both.
My signature below certifies that all of the information reported is complete and correct.
