Www.jvs-socal.org



[pic]

NON-FILING OF U.S. INCOME TAX RETURN

Directions:

Dependent Students: If you are a dependent student and did not file a 2020 federal income tax return, you and your parent(s) must complete this entire form.

Independent Students: If you are an independent student and did not file a 2020 federal income tax return, fill out the student and spouse (if applicable) portion of Section A and sign Section C.

|STUDENT INFORMATION |

|Name (Last, First, Middle Initial) |Birth Date |Social Security Number |

| | |(Last four digits only) |

| | | |

|PARENT INFORMATION |

|Mother/Stepmother Name (if applicable) |

|Father/Stepfather Name (if applicable) |

|□ SECTION A. Non-filing of U.S. income tax return for student/spouse |

|Complete this section if you and/or your spouse did not file and were not required to file a federal income tax return this year. Please list |

|all forms of income, including wages, earnings on savings and investments, child support, unemployment, welfare, and other income you and/or |

|your spouse received this year. If you filed a federal income tax return this year, do not file out Section A of this form. Instead, send a |

|photocopy of your signed federal tax return from this year to JVS. |

| |

|Student’s Income |

|Employer’s name or source of income |2020 Earnings |

| | |

| | |

|Spousal Income |

|Employer’s name or source of income |2020 Earnings |

| | |

| | |

|□ SECTION B. Non-filing of U.S. income tax return for parents |

|Complete this section if your parent(s) did not file and were not required to file a 2020 federal income tax return. Please list all forms of |

|income, including wages, earnings on savings and investments, child support, unemployment, welfare, and other income used to support your |

|family. If your parent(s) filed a 2020 federal income tax return, do not file out Section B of this form. Instead, send a photocopy of your |

|parent(s) signed 2020 federal tax return to JVS. |

|Parental Income |

|Employer’s name or source of income |Name of Parent |2020 Earnings |

| | | |

| | | |

|□ SECTION C. Certification |

|Student statement: I certify that federal law did not require me to file a 2020 federal income tax return. I certify that all of the |

|information on this form is true and correct to the best of my knowledge. |

|Student Signature |Date Signed |

| | |

|Parental statement: I/we certify that federal law did not require me/us to file a 2019 federal income tax return. I/we certify that all of the|

|information on this form is true and correct to the best of my/our knowledge. |

|Mother/Stepmother Signature |Date Signed |

| | |

|Father/Stepfather Signature |Date Signed |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download