Student Name _____________________________________________ Student ID or SSN _________________________
2017-18 Parent Nontax Filers
(Verification of 2015 Income Information)
Please return this completed form and all other required materials to:
Ottumwa Campus: Indian Hills Community College, Attn. Financial Aid, 525 Grandview Avenue, Ottumwa, Iowa 52501
Fax: 641-683-5741, Phone: 800-726-2585, ext. 5262 or 641-683-5262, email us at: OneStop@indianhills.edu
Centerville Campus: Indian Hills Community College, 721 North First Street, Centerville, IA 52544
Fax: 641-856-3158, Phone: 800-670-3641, ext. 2200 or 641-856-2143, ext. 2200 email us at: OneStop@indianhills.edu
To check the status of your documents, go to WebAdvisor and click the Financial Checklist, under the Financial Aid heading.
The instructions and certifications below apply to each parent included in the household. Complete this
sections 1-3 if the parents will not file and are not required to file a 2015 income tax return with the IRS.
1. Check the box that applies:
Neither parent was employed, and neither had income earned from work in 2015.
One or both parents were employed in 2015 and have listed below the names of all employers
and the amount earned from each employer in 2015. [Provide copies of all 2015 IRS W-2
forms issued to the parents by their employers]. List every employer even if the employer did
not issue an IRS W-2 form.
If more space is needed, provide a separate page with the student’s name and ID number at the top.
Annual Amount
Earned in 2015
employed income
i.e. babysitting,
2. Provide a copy of IRS Form W-2 for each source of 2015 employment income received (or an
equivalent document such as the Wage and Income Transcript.
If a W-2 is not available
The quickest way to obtain a copy of a Form W-2 is through your employer. If getting Forms W-2 from your
employers isn't possible, as an alternative, you can request a wage and income transcript
by using the IRS
Get Transcript service at www.IRS.gov Click on the “Get a tax transcript” link. Select “Get Transcript Online”
and follow instructions. You can also use Form 4506-T, Request for Transcript of Tax Return. Check the box
for Form W-2, specify which tax year(s) you need, and mail or fax the completed form. Allow 5 to 10 days
from the IRS received date to receive the transcript.
3. Certifications and Signatures
Each person signing below certifies that all of the information reported is complete and correct.
Student's Signature (Required)
Parent's Signature (Required)
