Student Name _____________________________________________ Student ID or SSN _________________________
2017-18 Student 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 the student and spouse, if the student is married. Complete this
section if the student and spouse will not file and are not required to file a 2015 income tax return with the IRS.
1. Check the box/es that applies:
The student was not employed and had no income earned from work in 2015.
The student was employed in 2015 and has 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
t
o the student by their employers]. List every employer even if the employer did not issue
an
IRS W-2 form
The spouse was not employed and had no income earned from work in 2015.
The spouse was employed in 2015 and has 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
t
o the spouse 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.
Student/Spouse
Name
Employer’s Name
Annual Amount
Earned in 2015
Check if self-
employed income
i.e. babysitting,
mowing, etc.
(Example) John Smith
Suzy’s Auto Body Shop
$2,000.00
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)
Spouse’s Signature (if spouse did not file a return)
Table 1-1. 2015 Filing Requirements Chart for Most Taxpayers
Note. You must file a return if your gross income was at least the amount shown in the last column.
IF your filing status is. . .
AND at the end of 2015
you were
*
. . .
THEN file a return if your gross income
**
was at least. . .
Single
under 65
$10,300
65 or older
$11,850
Head of household
under 65
$13,250
65 or older
$14,800
Married filing jointly
***
under 65 (both spouses)
$20,600
65 or older (one spouse)
$21,850
65 or older (both spouses)
$23,100
Married filing separately
any age (if your spouse itemizes
deductions)
$4,000
Qualifying widow(er)
with dependent child
under 65
$16,600
65 or older
$17,850
*
If you were born before January 2, 1951, you are considered to be 65 or older at the end of 2015. (If your spouse died in 2015 or if you
are preparing a return for someone who died in 2015, see Pub. 501.)
**
Gross income means all income you receive in the form of money, goods, property, and services that isn't exempt from tax, including
any income from sources outside the United States or
from the sale of your main home (even if you can exclude part or all of it). It also
includes gains, but not losses, reported on Form 8949 or Schedule D. Gross income from a business means, for example, the amo
unt
on Schedule C, line 7, or Schedule F, lin
e 9. But, in figuring gross income, don't reduce your income by any losses, including any loss
on Schedule C, line 7, or Schedule F, line 9.
Don't include any social security benefits unless (a) you are married filing separately and
you lived with your spo
use at any time in 2015 or (b) one-half of your social security benefits plus your other gross income and any tax-
exempt interest is more than $25,000 ($32,000 if married filing jointly). If (a) or (b) applies, see the Instructions for For
m 1040 or Pub.
91
5, Social Security and Equivalent Railroad Retirement Benefits, to figure the taxable part of social security benefits you must include
in gross income.
***
If you didn't live with your spouse at the end of 2015 (or on the date your spouse died) and your gross income was at least $4,000,
you must file a return regardless of your age.