Verification Of Earned Income For 2015 For Student Non-Filers printable pdf download

Verification Of Earned Income For 2015 For Student Non-Filers

VERIFICATION OF EARNED INCOME FOR 2015 FOR STUDENT NON-FILERS

Student’s Name: ____________________________ Student ID: _________________ Date: _____________

Your FAFSA has been selected for verification and you reported that you were not required to file a tax return

for 2015. Due to federal regulations we are required to verify this information. Please complete the

information below and return this form to our office within 14 days of receipt of this notification. If the

information is not received it may result in a delay of the disbursement of your financial aid and this could

impact the status of your student account.

*Failure to return this form may jeopardize your financial assistance*

If a tax return was filed, you must utilize the IRS Data Retrieval System on the FAFSA, or submit a copy of your IRS Return

Transcript. You are required to file a tax return if you have earned $6100.00 or more for the 2015 year.

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, the amount earned from

each employer in 2015, and whether an IRS W-2 form is provided. This also includes any work study earnings. You must

attach copies of any W-2 form(s) and/or 1099 form(s) received in 2015. List below all of the sources and amounts of

money received January 1, 2015 through December 31, 2015. List every employer even if the employer did not issue an

IRS W-2 form.

A copy of ALL W-2s is REQUIRED

Employer’s Name

2015 Amount

Did you receive a W-2?

Bob’s Auto Shop (example)

$2000.00 (example)

Yes or No?

If no, you must explain why

By signing this worksheet you certify that all of the information reported on it is complete and correct.

__________________________________________________ _______ __________________

Student’s Signature (required)

Date

Clark University Office of Financial Assistance 950 Main Street Worcester, MA 01610

Phone: 508-793-7478 Fax: 508-793-8802

Email:

finaid@clarku.edu

Verification Of Earned Income For 2015 For Student Non-Filers