For assistance completing this form contact the or E-mail ...

VERIFICATION

TAX RETURN NON-FILER

For assistance completing this form contact the Financial Aid Contact Center at (281)290-2700 or E-mail FACC@Lonestar.edu

2017--2018

Student ID:

Student's Name:

Last

First

MI

Date of Birth:

/

/

Month

Day

Year

Phone:

LSC E-mail:

Your 2017?2018 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before awarding Federal Student Aid, we may ask you to confirm the information you (and your parent(s) or spouse, if applicable) reported on your FAFSA. To verify that you provided correct information, we will compare your FAFSA with the information on this form and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You must complete and sign this form, attach any required documents, and submit the form and other required documents to the Financial Aid Department. Additional information may be requested.

Income Information - Tax Return Non-Filers

Complete this section if you, the student (and, if married, your spouse), and/or the student's parent(s) (if dependent student) will not file and are not required to file a 2015 income tax return with the IRS.

Student (and spouse, if applicable) section. Check the box that applies:

The student (and, if married, the student's spouse) was not employed and had no income earned from work in 2015.

The student (and/or the student's spouse if married) 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 attached. Attach copies of all 2015 W-2 forms issued to you (and, if married, to your spouse) by employers. List every employer even if the employer did not issue an IRS W-2 form. If more space is needed, attach a separate page with your name and student ID at the top

Employer's Name

Suzy's Auto Body Shop (example)

2015 Amount Earned

$2,000.00 (example)

Parent section (dependent students only). Check the box that applies:

The parent(s) was not employed and had no income earned from work in 2015.

The parent(s) was employed in 2015 and has listed below the names of all the parent(s) employers, the amount earned from each employer in 2015, and whether an IRS W-2 form is attached. Attach copies of all 2015 W-2 forms issued to the parent(s) by employers. List every employer even if the employer did not issue an IRS W-2 form. If more space is needed, attach a separate page with the student's name and student ID at the top.

Employer's Name

Suzy's Auto Body Shop (example)

2015 Amount Earned

$2,000.00 (example)

V12.05.2016

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Student ID:

Student's Name:

Last

First

MI

The student must sign this form.

If married, the spouse's signature is optional (unless the student filed taxes and the spouse is a non -filer or if student and spouse

married after the end of the tax year).

If dependent student, the parent that is the non-filer must sign. If neither parent filed a tax return, both parents must sign t his

form.

CERTIFICATION

I certify that the information provided herein is true and correct to the best of my knowledge. I also understand that if I p urposely give false or misleading information in connection with my application for federal aid, I may be subject to a fine of up to $20,00 0, sent to prison, or both.

Student Signature:

Date:

Spouse's Signature:

Date:

Parent's Signature:

Date:

Parent's Signature:

Date:

Please return this completed form to your nearest campus:

LSC-CyFair Financial Aid Office/CASA 105

9191 Barker Cypress Road Cypress, TX 77433-1383

LSC?North Harris Financial Aid Office/SSB 102

2700 W.W. Thorne Drive Houston, TX 77073-3499

LSC?Tomball Financial Aid Office/S 114

30555 Tomball Parkway Tomball, TX 77375-4036

LSC?Montgomery Financial Aid Office/Building C

3200 College Park Drive Conroe, TX 77384-4500

V12.05.2016

LSC?Kingwood Financial Aid Office/SCC 150

20000 Kingwood Drive Kingwood, TX 77339-3801

LSC?University Park Financial Aid Office/Building 12 Suite 233

20515 SH 249 Houston, TX 77070

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