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Independent Student Verification of Non-Filing for Tax Year 2023-2024

"*" indicates required fields

Your financial aid application was selected by the U.S. Department of Education to undergo a process called verification. You indicated on your financial aid application that you did not or will not file a 2021 IRS Income Tax Return.

You and your spouse (if you are married), must complete this form. Both the student and spouse must sign and submit this form. The form must be submitted to the Financial Aid Office to continue the review process and determine your eligibility for federal student aid.

A. Student Information

Student Information*







B. Student's 2021 IRS Income Tax Return Filing Status

Student Name*







Select one of the options provided below. If you are married, or remarried, you must enter information for your spouse in Section C.*




Is the student married?


D. Certification and Signatures

Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional information is attached. The student MUST sign and date this section. I understand that purposely giving false or misleading information could result in a fine, imprisonment or both as it relates to my reporting information to the U.S. Department of Education.
Clear Signature