Return to: Office of Financial Aid
P.O. Box 6804 GH-146 Fullerton,
CA 92834-6804 Enter Student’s
CWID Here:
STUDENT (AND SPOUSE) 2019 TAX FILING STATEMENT (2021-2022)
To verify student (and student's spouse, if married) 2019 income and wages information, you must provide the information below.
CERTIFICATION:
By signing this form, I certify that all of the information reported on this form and any attachments hereto is true, complete and accurate.I agree to provide additional
proof of the information reported, if requested to do so. I also certify that I have read the terms and conditions section of the CSU Fullerton, Financial Aid website
(http://www.fullerton.edu/financialaid/info/Terms.php) *Signature is required.
*Student Signature: ______________________________________________________________________________ Date _________________________
Print Student’s Name: ___________________________________________________________________________
CWID __________________________
Warning: If you give false or misleading information on documents submitted to the Office of Financial Aid, you may be fined, be sentenced to jail or both.
Instructions for completing this form:
Complete section A whether or not you, the student (and your spouse), have already completed your 2019 U.S. Federal Tax Return
Do NOT email any IRS Tax Return Transcripts or other IRS documents to our office to protect your privacy.
Incomplete documents will not be returned. They will be disposed of in a secure manner, per university policy. This will delay processing.
Section A: Student Income Information
Did you, the student, file a 2019 income tax return with the IRS? (if married, include spouse)
Yes (select one option from the column below)
No (select one from the column below)
Student Nontax Filers
I was not employed and had no income earned from
work in 2019.
- Independent students as defined on the FAFSA MUST provide
confirmation of non-filing from the IRS through form 4506-T (box 7),
or online through IRS dated on or after October 1, 2019, or written
statement of non-filing
- Dependent students as defined on the FAFSA are NOT required to
provide confirmation of non-filing.
I was employed in 2019 but not required to file.
- Submit a copy of all your 2019 Form W-2(s) from your employer
or your 2019 IRS Wage and Income tax Transcript. OR 1099s.
- Independent students as defined on the FAFSA MUST provide
confirmation of non-filing from the IRS through form 4506-T
(box 7), or online through IRS dated on or after October 1, 2019,
or written statement of non-filing
- List the names of all your 2019 employer(s) and the amount
earned from each employer in 2019
$2,000.00
Student Tax Filers
I am unable to or choose not to use the IRS DRT
- Submit your 2019 Tax Return Transcript or a signed copy of the
2019 1040 Tax Returns along with schedules 1,2,3 if applicable
- Obtain your transcript from the IRS website http://www.irs.gov and
click on "Get Transcript of Your Tax Records" OR by calling
(800)908-9946 to request an IRS Tax Return Transcript for the 2019
year
My filing status was Married Filing Jointly; however, I
have since separated. Date of separation: ________________
- Submit a SIGNED copy of the 2019 Tax Return Transcript or 2019
1040 Tax Returns along with schedules 1,2,3 if applicable
- AND copies of all W2s, as they are required to determine your
portion of the income
I/we have filed a Tax Extension
- If tax extension is beyond the 6 month October 15, 2019 deadline:
- Submit form 4868, unexpired IRS approval of extensions
beyond the automatic 6-month extension
- All W2s, a signed statement with estimated 2019 income and/
or business related income amount(s) (if applicable), a signed
copy of your 2018 federal tax return form (1040, 1040A or
1040EZ), and provide confirmation of non-filing from the IRS
through
form 4506-T (box 7) dated on or after October 1, 2019
I/we have filed a 2019 Foreign Tax Return
- Submit a signed and translated copy of your foreign tax return,
which shows the 2019 Adjusted Gross Income (AGI) and taxes paid.
Example:
Suzy's Auto Body Shop
Employer's Name
2019 Amount Earned
Example: