Certification Of Unfiled Tax Return For Student Non-Tax Filers

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PrattMWP Financial Aid Office
Phone: (315) 797-0000 ext. 2222
310 Genesee Street
Fax: (315) 797-9349
Utica, NY 13502
Email: finaid@mwpai.edu
CERTIFICATION OF UNFILED TAX RETURN
(Student
)
Non-Tax Filers only
This form is only to be completed in the event that a student was not required to file a 2015 federal income tax
return.
A. Reason for non-filing
I, the student, did not file a 2015 Federal Income Tax Return. My reason for not filing an income tax
return was:
(please check one)
I received no taxable or untaxable income during tax year 2015.
I did receive taxable or untaxable income during tax year 2015; however the amount received did not require that
I file a federal income tax return. My total income received was $ _________________.
Please attach copies of all 2015 W-2 forms and complete the below table.
Employer’s Name
W-2 Attached (Y/N)
Income Earned in 2015
(Example) ABC’s Auto Body Shop
Y
$ 4,500.00
$
$
B. Verification of Non-Filing Letter
ALL STUDENTS must also attach documentation from the IRS dated on or after October 1, 2016 that indicates a 2015
IRS income tax return was not filed.
Please refer to the attached instructions, “Requesting a Verification of Non-Filing Letter.”
C. Signature
The student signing below certifies that all of the information reported is complete and correct.
______________________________________________________________________________
Print Student’s Name
______________________________________________________________________________
Student’s Signature
Date

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