Verification Of Other Untaxed Income Form - 2014 printable pdf download

Verification Of Other Untaxed Income Form - 2014

Verification of Other Untaxed Income for 2014

Student Name: ______________________________

Furman ID: __________________

Provide copies of all 2014 IRS W-2 forms issued by all employers.

If any item does not apply, enter “N/A” for Not Applicable where a response is requested, or

enter 0 in an area where an amount is requested.

If the student was required to provide parental information on the FAFSA answer each question

below as it applies to the student and the student’s parent(s) whose information is on the

FAFSA.

If the student was not required to provide parental information on the FAFSA, answer each

question below as it applies to the student (and the student’s spouse, if married) whose

information is on the FAFSA.

To determine the correct annual amount for each item: If you paid or received the same

dollar amount every month in 2014, multiply that amount by the number of months in 2014 you

paid or received it. If you did not pay or receive the same amount each month in 2014, add

together the amounts you paid or received each month.

If more space is needed, provide a separate page with the student’s name and ID number at the

top.

A. Payments to tax-deferred pension and retirement savings

List any payments (direct or withheld from earnings) to tax-deferred pension and retirement

savings plans (e.g., 401(k) or 403(b) plans), including, but not limited to, amounts reported

on W-2 forms in Boxes 12a through 12d with codes D, E, F, G, H, and S.

Name of Person Who Made the Payment

Total Amount Paid in 2014

B. Child support received

List the actual amount of any child support received in 2014 for the children in your

household.

Do not include foster care payments, adoption payments, or any amount that was court-

ordered but not actually paid.

Name of Adult Who

Name of Child For Whom

Amount of Child Support

Received the Support

Support Was Received

Received in 2014

Verification Of Other Untaxed Income Form - 2014