Month ##, Year



DEPENDENT STUDENT NON FILER STATEMENT

We received your Free Application for Federal Student Aid (FAFSA) and it was indicated that you will not file a 2018 U.S. Income Tax Return. Your financial aid will not be complete until we receive this signed statement.

If you, the student, did not file a 2018 U.S. Income Tax Return, by signing this form you are certifying that you are not required to file a U.S. Income Tax Return because of one of the following reasons, please check the appropriate statement:

____ The student was not employed and had no income earned from work in

2018.

____ The student was employed, however did not earn enough to be

required to file a 2018 U.S. Income Tax Return. If you did work, but were not

required to file, please submit a copy of your 2018 W2 form(s) along with the signed

non filer statement.

Student Name:___________________________________ J#____________________

Student Signature:______________________________________________________________

Date:_________________________________________________________________________

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