Fillable Parent 2017 IRS Status Verification 2019 20 (Blue Ridge Community College)

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Parent 2017 IRS Status Verification 2019 20 (Blue Ridge Community College)

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The Parent 2017 IRS Status Verification 2019 20 (Blue Ridge Community College) form is 2 pages long and contains:

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Country of origin: US
File type: PDF

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Please note this is a multi-page form. Please make sure that you print, complete, and submit both pages.
Parent(s) 2017 IRS Income Tax Return Filing Status Verification
Your FAFSA was selected by the U.S. Department of Education for a process called verification. BRCC is required by federal law
to compare the FAFSA with the information on this worksheet. Your parent(s) indicated on your FAFSA that they did not or will
not file a 2017 IRS Income Tax Return. You, your parent, and parent’s spouse if married, must complete this form. You and your
parent must sign and submit the form to the Financial Aid Office to determine eligibility for federal student aid. Incomplete forms
or conflicting information will cause delays in the processing of your aid. Instructions for looking up your Student I.D. can
be found here: Find your student ID here.
A. Student Information:
Last Name: _______________________________________ First Name: _________________________________________
Student ID (required): _________________ Date of Birth: ___________________ Phone Number: _________________
B. Parent(s) 2017 IRS Income Tax Return Filing Status:
Please select the ONE option from the choices below that applies to you, the parent. In some cases you will need to provide
additional documents. If additional space is needed please attach an additional sheet with the required information and the
student’s name and student ID number at the top. The student and parent must sign and date the additional sheet.
Parent’s Full Name: _______________________________________________________________________
______ I worked and had income in 2017. I did not file, and was not required to file, 2017 income taxes. I have listed all sources
of work income below.
Income Source/Employer Name
Amount Earned in 2017
Example: Dan’s Autobody
$2500.00
$
$
$
$
______ I have been granted a 2017 income tax filing extension. As required:
I have attached a copy of the extension granted by the U.S. Internal Revenue Service (IRS);
I have attached a copy of a completed IRS Form 4868;
I have listed my sources of income in the box below; and
If I am self-employed, I have attached a signed statement estimating my 2017 AGI and taxes paid.
Income Source/Employer Name
Amount Earned in 2017
Example: Dan’s Autobody
$2500.00
$
$
$
$
______ I was not employed in 2017 and earned no income from work.
Please note this is a multi-page form. Please make sure that you print, complete, and submit both pages.
Parent(s) 2017 IRS Income Tax Return Filing Status Continued:
Please select the ONE option from the choices below that applies to you, the parent’s spouse if applicable. In some cases you
will need to provide additional documents. If additional space is needed please attach an additional sheet with the required
information and the student’s name and student ID number at the top. The student and parent must sign and date the additional
sheet.
Spouse’s Full Name: __________________________________________________________________
______ I worked and had income in 2017. I did not file, and was not required to file, 2017 income taxes. I have listed all sources
of work income below.
Income Source/Employer Name
Amount Earned in 2017
Example: Dan’s Autobody
$2500.00
$
$
$
$
______ I have been granted a 2017 income tax filing extension. As required:
I have attached a copy of the extension granted by the U.S. Internal Revenue Service (IRS);
I have attached a copy of a completed IRS Form 4868;
I have listed my sources of income in the box below; and
If I am self-employed, I have attached a signed statement estimating my 2017 AGI and taxes paid.
Income Source/Employer Name
Amount Earned in 2017
Example: Dan’s Autobody
$2500.00
$
$
$
$
______ I was not employed in 2017 and earned no income from work.
C. Certification and Signatures
Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional
information is attached. The student and one parent MUST sign and date this section in blue or black ink.
WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced to jail,
or both.
Student’s Signature: _________________________________________________ Date: ____________________
Parent’s Signature: __________________________________________________ Date: ____________________
Please return this completed form in one of the following ways: upload it using the link to the form on your To-Do list in SIS, fax
to 540-234-8189, scanned e-mail attachment to finaid@brcc.edu, or mail to Blue Ridge Community College, Office of Financial
Aid, Box 80, One College Lane, Weyers Cave, VA 24486. Please call 855-844-3631 if you have questions.
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Parent 2017 IRS Status Verification 2019 20 (Blue Ridge Community College)

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Completed 26 July 2020

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