Parent(s) 2018 IRS Income Tax Return Filing Status Verification
Your student’s financial aid application was selected by the U.S. Department of Education to undergo a process called
verification. You indicated on your student’s financial aid application that you did not or will not file a 2018 IRS
Income Tax Return.
You and your spouse, if you are married, must complete this form. You and your student must sign and submit this
form. The form must be submitted to the Financial Aid Office to continue the review process and determine your
eligibility for federal student aid.
A. Student Information
__________________________________________________ ________________
Student’s Name (Last, First, M.I.) Student ID - REQUIRED
B. Parent(s) 2018 IRS Income Tax Return Filing Status
Select ONE
option from the three provided below if you are the parent whose information was provided on the
students financial aid application. . If you married, or remarried, you must enter information for your spouse below.
Parent Name: _________________________________________________________________________________________
(First, Middle Initial, Last)
I earned income in 2018 but did not file nor was I required to file, an income tax return. I have listed my sources
of income and amounts below. If additional space was needed I have attached
an additional sheet with the
required information. My student’s name and student ID has been placed at the top of the additional sheet.
Income Source/Employer Name Amount Earned in 2018
Example: Dan’s Autobody $2500.00
I have been granted a 2018 income tax filing extension. n as required :
I h
ave attached a copy of the IRS's approval of an extension beyond the automatic six-month extension.
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 AGI 2018 and taxes paid.
If additional space was needed I have attached an additional sheet with the required information. My student’s
name and student ID has been placed at the top of the additional sheet.
Income Source/Employer Name Amount Earned in 2018
Example: Dan’s Autobody $2500.00
I was not employed in 2018 and earned no income from work.
Spouse Name (if Parent is married): _______________________________________________________________________
(First, Middle Initial, Last)
I earned income in 2018 but did not file, nor was I required to file, an income tax return. I have listed my sources
of income and amounts below . If additional space was needed I have attached an additioanl sheet with the required
information. My student’s name and student ID has been placed at the top of the additional sheet.
Income Source/Employer Name Amount Earned in 2018
Example: Dan’s Autobody $2500.00
I have been granted a 2018 income tax filing extension. As required:
I h
ave listed my sources of income in the box below; and
If I am sself-employed, I have attached a signed statement estimating my 2018 AGI and
taxes paid.
If additional space was needed I hav
e attached an additional sheet with the required information. My student’s
name and student ID has been placed at the top of the additional sheet.
Income Source/Employer Name Amount Earned in 2018
Example: Dan’s Autobody $2500.00
I was not employed in 2018 and had 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.
WARNING: If you purposely give false or misleading information on this worksheet may be fined, sentenced to jail,
or both.
______________________________________________________________________ _______________
Student’s Signature
Date
______________________________________________________________________ _______________
Parent Signature Date
I
ha
ve attached a copy of the IRS's approval of an extension beyond the automatic six-month extension.
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signature
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signature
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