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Student’s Name: ______________________________________________ SSN: __________________________

Verification of 2015 Income Information for Individuals with Unusual Circumstances

Individuals Granted a Filing Extension by the IRS

An individual, who is required to file a 2015 IRS income tax return and has been granted a filing extension by the IRS, must provide:



A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income Tax Return,’’ that was filed with the

IRS for tax year 2015;



A copy of the IRS's approval of an extension beyond the automatic six-month extension if the individual requested an additional extension of the

filing time for tax year 2015; and



A copy of IRS Form W–2 for each source of employment income received for tax year 2015 and, if self-employed, a signed statement certifying

the amount of the individual’s Adjusted Gross Income (AGI) and the U.S. income tax paid for tax year 2015.

Individuals Who Filed an Amended IRS Income Tax Return

An individual who filed an amended IRS income tax return for tax year 2015 must provide:



A 2015 IRS Tax Return Transcript or any other IRS tax transcript(s) that includes all of the income and tax information required to be

verified; and



A signed copy of the 2015 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was filed with the IRS.

Individuals Who Were Victims of IRS Tax-Related Identity Theft

An individual who was the victim of IRS tax-related identity theft must provide:



A Tax Return Database View (TRDBV) transcript obtained from the IRS, or any other IRS tax transcript(s) that includes all of the income and

tax information required to be verified; and



A statement signed and dated by the tax filer indicating that he or she was a victim of IRS tax-related identity theft and that the IRS is aware of

the tax-related identity theft.

Individuals Who Filed Non-IRS Income Tax Returns

An individual who filed or will file a 2015 income tax return with the relevant taxing authority of a U.S. territory, commonwealth, or with a foreign

central government must provide:



A transcript that was obtained at no cost from the relevant taxing authority of a U.S. territory (Guam, American Samoa, the U.S. Virgin Islands)

or commonwealth (Puerto Rico and the Northern Mariana Islands), or a foreign central government, that includes all of the tax filer’s income

and tax information required to be verified for tax year 2015; or



If a transcript cannot be obtained at no cost from the relevant taxing authority, a signed copy of the 2015 income tax return(s).

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