Verification Worksheet Page 5

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Student SU ID#: _800____________________
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 (that will only include information from the original tax return and does not
have to be signed), 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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