USA Funds University
Verification Documentation
Requirements: The Tax
Return Transcript
OASFAA Summer Drive In 2012
Aug. 21, 2012
Special Note
These materials are for the benefit of financial aid professionals and other campus administrators. They are intended to provide current facts and information and are not intended to be legal advice. These materials
contain information related to Federal Title IV student aid programs and have neither been reviewed nor approved by the U.S. Department of Education. You are encouraged to seek your own competent legal counsel in connection with the topics covered in these materials. USA Funds® disclaims all responsibility for
any claim arising from reliance on the information provided.
© Copyright 2012 United Student Aid Funds, Inc. All Rights Reserved.
Questions regarding the content of this publication should be addressed to USA Funds University, P.O. Box 6028 Indianapolis, IN 46206-6028 or by calling (317) 806-0208.
Verification Documentation Requirements
The U.S. Department of Education continues to place great emphasis on the integrity of its federal financial aid programs.
An important part of this effort is achieving a high level of accuracy for financial and other information provided by
applicants on the Free Application for Federal Student Aid. Verification of FASFA data helps schools accurately and
equitably determine the types and amounts of federal funding students will receive.
Many changes recently introduced by ED affect the verification process, some of which schools had the opportunity to
implement as early as the 2010-2011 award year. For example, revised regulations already allow unaltered tax data
retrieved directly from the IRS by FAFSA applicants to be used for verification purposes, in lieu of collecting tax returns
and other income documentation.
Recent regulatory changes also modify the type and number of data elements that must be verified for the 2012-2013
award year. In the final regulations published in the Federal Register on Oct. 29, 2010, as well as in subsequent guidance,
ED clarified primary and alternative documentation requirements for each of those data elements.
Required Verification Items
34 CFR 668.56.
Federal Register, Vol. 76, No. 134, p. 41231-41233.
Dear Colleague Letter GEN-11-13.
When a student's application is selected for verification by the CPS, certain data elements must be documented and
validated by the school. The regulations specify that the minimum data elements schools must verify and the acceptable
documentation for each data element will be defined by ED on an annual basis and could change from one year to the
next. Requirements for each year will be outlined in the Federal Register approximately four to six months prior to the
start of each application cycle.
On July 13, 2011, the Department informed schools of the FAFSA data elements that must be verified for the 2012-2013
award year. The Federal Register and subsequent guidance listed the documentation an applicant must provide to the
school to verify the accuracy of each required data element. The required number of data elements ranges from five for
non-tax filers to 11 for tax filers.
1
2012-2013 FAFSA Information Required to Be Verified
Items required for all applicants selected for verification:
u
Household size.
u
Number in college.
u
Child support paid.*
u
Supplemental Nutrition Assistance Program, commonly known as Food Stamps.*
* Information must be verified if reported on the FAFSA.
Yes
Was or will a
federal income
tax return be
filed?
Additional required verification items:
u
Adjusted gross income.
u
Federal income taxes paid.
u
Untaxed IRA distributions.
u
Untaxed pensions.
u
Education credits.
u
IRA deductions.
u
Tax exempt interest income.
No
Additional required verification item:
u
Income earned from work.
Trainer’s Tidbit
2011-2012 Federal Student Aid Handbook, p. AVG-80.
"The school may also select additional applications for verification beyond those required. In these cases the school
decides which items to verify: it can choose any that must be verified on CPS-selected applications, or it can choose
different items."
NOTES
2
Acceptable Documentation
34 CFR 668.57.
Federal Register Vol. 76, No. 134, p. 41231-41233.
Dear Colleague Letter GEN-11-03.
Dear Colleague Letter GEN-11-13.
The Program Integrity Final Rule published by the U. S. Department of Education on Oct. 29, 2010, made numerous
changes to verification regulations. One of the most prominent of those changes replaced the standard required
verification data items with a list of new data items that ED plans to revise annually. A summary of acceptable
documentation for each required verification item is provided in the Appendix.
Income Verification for Tax Filers
When using FAFSA on the Web, students (and/or parents of dependent students) who indicate they filed federal income
tax returns will be encouraged to retrieve their IRS income data to populate the appropriate FAFSA fields.
For the 2012-2013 award year, one significant change is the Department’s expectation that schools will rely on the
information provided by the IRS as the primary source of documentation for verification purposes. According to Dear
Colleague Letter GEN-11-03:
Since most applicants can quickly and easily access IRS data through the FAFSA-IRS Data Retrieval process, we no longer
consider it reasonable for an institution to accept anything less reliable than direct IRS-supplied evidence for verification of
income data. Therefore, if an applicant selected for verification has not successfully transferred information from the IRS, or
one who did transfer the information but then changed it, the Department expects the institution to require the applicant,
and if necessary the applicant's parents, to provide an official IRS transcript of their Federal income tax information.
ED stated that if applicants choose not to use the IRS data retrieval process, before being allowed to proceed with
completing their applications, they will be informed that:
u
Their applications may be selected for verification.
u
If selected, they will be asked to provide documentation obtained from the IRS.
In the Federal Register published July 13, 2011, ED provided a priority order for the type of documentation schools must
use to document FAFSA data related to income for tax filers for the 2012-2013 award year.
u
First priority: Unaltered IRS data retrieved by tax filers using FOTW.
u
Second priority: An IRS tax transcript for 2011, if IRS data was not retrieved or if it was retrieved and then changed.
u
Third priority: A signed copy of the tax filer’s 2011 federal income tax return, but only if the school determines that
obtaining an IRS tax transcript is not possible.
IRS data retrieved by the tax filer while correcting the FAFSA is considered acceptable documentation, even though it was
not retrieved with the initial application. The newly-retrieved data can serve to document the answers on the application
instead, and any applicable requests for alternate documentation could be cancelled.
NOTES
3
IRS Data Retrieval Process
The IRS data retrieval process became available on Feb. 5, 2012, for the 2012-2013 FAFSA. The FOTW application now will
ask for details about the tax filer to determine if the IRS data retrieval process will be accessible to the tax filer. The system
will require the use of the tax filer’s own financial records to complete the FAFSA and the answers to these questions will
not appear on the ISIR. Examples include:
u
Tax filing status of “married filing separately.”
u
Tax filing status of “head of household” (married tax filers only).
u
Amended tax return filed.
u
Foreign tax return filed.
u
Tax return filed recently.
FAFSA Question Numbers
For federal income tax filers who are eligible to use the IRS data retrieval process, the following data is available for
retrieval and transfer from the IRS to the FAFSA using FOTW:
2012-2013 FAFSA Question Numbers
Tax Return Information
Student
Parent
Type of tax return filed
33
80
Adjusted gross income
35
83
Income tax
36
84
IRS exemptions
37
85
Education credits
43a
91a
IRA deductions and payments
44b
92b
Tax-exempt interest income
44d
92d
Untaxed IRA distributions
44e
92e
Untaxed pensions
44f
92f
Trainer’s Tidbit
2012-2013 FAFSA, Q44i and Q92i.
One tax credit considered untaxed income for the 2012-2013 award year is not included as a part of the IRS data
retrieval process:
u
First-time homebuyer tax credit.
– 1040 Line 67.
Because this credit appears on the tax return and is not explicitly excluded from Federal Methodology formulas, it must
be counted as untaxed income and verified for selected applicants.
The Making Work Pay tax credit expired at the end of the 2010 tax year and was not renewed for 2011.
4
Data Transfer
If a successful match is made with records on file with the IRS, available data is retrieved. The tax filer may check the
“Transfer My Tax Information into the FAFSA” box and click the “Transfer Now” button, or exit the retrieval process by
checking the “Do Not Transfer My Tax Information and Return to the FAFSA” box and clicking the “Do Not Transfer” button.
Identifying Unaltered IRS Data
If an applicant makes changes to any transferred data, the “Transferred from the IRS” labels will disappear from the FOTW
data entry screens. A comment on the Institutional Student Information Record will indicate that information was
retrieved, but was changed by the user before the FAFSA was submitted. For dependent students, a separate code will be
provided to report on the dependent student’s parent’s data retrieval status.
High School Flag
X
Student IRS Req Flag
XX
Parent IRS Req Flag
XX
Auto Zero EFC Flag
XXX
EFC Change Flag XXXXXXXX
SNT Flag
XXX
5
IRS Request Flags
To determine whether an application contains unaltered IRS data, look for code “02” in the IRS Request Flag field of the
“FAA Information” section of the ISIR. This is the only status that permits the school to consider the data that was retrieved
from the IRS as sufficiently documented, rather than requiring applicants to provide additional documentation.
2012-2013 Request Flag Values
Code
Description
Blank
IRS Data Retrieval Tool not available in the application method utilized by the student (for example, paper
FAFSA, EDE, or FAA Access to CPS Online).
00
Not eligible to use the IRS Data Retrieval Tool and was therefore not presented with the option to use it in
FAFSA on the Web.
01
Presented with the option to use the IRS Data Retrieval Tool in FAFSA on the Web and elected to use it, but
did not transfer IRS data into the FAFSA.
02
IRS data was transferred from the IRS and was not changed by the user prior to submission of an application
or correction.
03
IRS data was transferred from the IRS and changed by the user prior to submission of an application or
correction.
04
IRS data was transferred from the IRS and then changed by the user on a subsequent transaction.
05
Presented with the option to use the IRS Data Retrieval Tool in FAFSA on the Web, but did not elect to use it.
06
IRS data was transferred from the IRS, but a subsequent change made him or her ineligible to use the IRS
Data Retrieval Tool.
Provided from 2012-2013 ISIR Guide, p. 25-26.
Follow-up Communications
Beginning April 1, 2012, ED will send email communications to students and/or parents who were eligible to retrieve IRS
data to populate the FAFSA, but chose not to do so. The email will encourage the tax filer to retrieve IRS data through the
FAFSA corrections process. Each student and/or parent with this status will receive one follow-up email from the
Department, with none sent to applicants with the Professional Judgment indicator.
NOTES
6
IRS Tax Transcripts
Federal Register, Vol. 76, No. 134, pages 41231-41233.
Dear Colleague Letter GEN-11-03.
Dear Colleague Letter GEN-11-13.
Upon request, the IRS provides tax filers with transcripts of their federal income tax returns. Increased reliance on tax
transcripts to validate FAFSA information means financial aid administrators need to be familiar with how these
documents can be obtained by students and parents, and how to review the information they contain.
Typically, transcripts are available for the current and past three years. The IRS makes two types of transcripts available:
u
Tax Return Transcript: Provides original answers for most line items on the tax return.
u
Tax Account Transcript: Provides some of the information found on a tax return transcript, along with any
adjustments made by the tax filer or the IRS after the original return was filed.
NOTES
7
Tax Return Transcript Sample (page 1 of 6)
This Product Contains Sensitive Taxpayer Data
Request Date: 05-31-2011
Response Date: 05-31-2011
Tracking Number: XXXXXXXXXXXX
Tax Return Transcript
SSN Provided: BBB-BB-BBBB
Tax Period Ending: Dec. 31, 2010
The following items reflect the amount as shown on the return (PR), and the amount
as adjusted (PC), if applicable. They do not show subsequent activity on the
account.
SSN: BBB-BB-BBBB
SPOUSE SSN: CCC-CC-CCCC
NAME(S) SHOWN ON RETURN: LYLE K & JENNIFER M LEE
ADDRESS: 123 MAIN STREET
SPRINGFIELD, OR 97477
FILING STATUS:
FORM NUMBER:
CYCLE POSTED:
RECEIVED DATE:
REMITTANCE:
EXEMPTION NUMBER:
DEPENDENT 1 NAME CTRL:
DEPENDENT 1 SSN:
DEPENDENT 2 NAME CTRL:
DEPENDENT 2 SSN:
DEPENDENT 3 NAME CTRL:
DEPENDENT 3 NAME CTRL:
DEPENDENT 4 NAME CTRL:
DEPENDENT 4 SSN:
IDENTITY THEFT PERSONAL ID NUMBER:
PREPARER SSN:
PREPARER EIN:
Married Filing Joint
1040
20111208
Apr. 15, 2011
0.00
5
LEE
AAA-AA-AAAA
LEE
DDD-DD-DDDD
LEE
EEE-EE-EEEE
XXXXX
XX-XXXX
Income
WAGES, SALARIES, TIPS, ETC:............................................. $118,036.00
TAXABLE INTEREST INCOME: SCH B:.............................................. $278.00
TAX-EXEMPT INTEREST:.......................................................... $0.00
ORDINARY DIVIDEND INCOME: SCH B:.............................................. $0.00
QUALIFIED DIVIDENDS:.......................................................... $0.00
REFUNDS OF STATE/LOCAL TAXES:.............................................. $1,050.00
ALIMONY RECEIVED:............................................................. $0.00
BUSINESS INCOME OR LOSS (Schedule C):......................................... $0.00
BUSINESS INCOME OR LOSS: SCH C PER COMPUTER:.................................. $0.00
CAPITAL GAIN OR LOSS: (Schedule D):....................................... $37,531.00
CAPITAL GAINS OR LOSS: SCH D PER COMPUTER:................................ $37,531.00
OTHER GAINS OR LOSSES: (Form 4797):.......................................... $0.00
TOTAL IRA DISTRIBUTIONS:...................................................... $0.00
TAXABLE IRA DISTRIBUTIONS:.................................................... $0.00
TOTAL PENSIONS AND ANNUITIES:.............................................. $4,191.00
TOTAL PENSION/ANNUITY AMOUNT:................................................. $0.00
RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E):................................. $0.00
RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E) PER COMPUTER:.................... $0.00
RENT/ROTALTY INCOME/LOSS PER COMPUTER:........................................ $0.00
ESTATE/TRUST INCOME/LOSS PER COMPUTER:........................................ $0.00
PARTNERSHIP/S-CORP INOCME/LOSS PER COMPUTER:.................................. $0.00
FARM INCOME OR LOSS (Schedule F):............................................. $0.00
FARM INCOME OR LOSS (Schedule F) PER COMPUTER: ............................... $0.00
UNEMPLOYMENT COMPENSATION:.................................................... $0.00
TOTAL SOCIAL SECURITY BENEFITS:............................................... $0.00
8
Tax Account Transcript Sample (page 1 of 1)
This Product Contains Sensitive Taxpayer Data
Request Date: 08-01-2011
Response Date: 08-01-2011
Tracking Number: XXXXXXXXXXXX
Account Transcript
FORM NUMBER: 1040
TAX PERIOD: Dec. 31, 2010
TAXPAYER IDENTIFICATION NUMBER:
SPOUSE TAXPAYER IDENTIFICATION NUMBER:
BBB-BB-BBBB
CCC-CC-CCCC
LYLE K & JENNIFER M LEE
123 MAIN STREET
SPRINGFIELD, OR 97477
--- ANY MINUS SIGN BELOW SIGNIFIES A CREDIT AMOUNT --ACCOUNT BALANCE:
ACCRUED INTEREST:
ACCRUED PENALTY:
ACCOUNT BALANCE
PLUS ACCRUALS
(this is not a
Payoff amount):
0.00
0.00
0.00
AS OF: April 11, 2011
AS OF: April 11, 2011
0.00
** INFORMATION FROM THE RETURN OR AS ADJUSTED **
EXEMPTIONS:
05
FILING STATUS:
Married Filing Joint
ADJUSTED GROSS
INCOME:
151,895.00
TAXABLE INCOME:
104,855.00
TAX PER RETURN:
14,401.00
SE TAXABLE INCOME
TAXPAYER:
0.00
SE TAXABLE INCOME
SPOUSE:
0.00
TOTAL SELF
EMPLOYMENT TAX:
0.00
RETURN DUE DATE OR RETURN RECEIVED DATE (WHICHEVER IS LATER)
PROCESSING DATE
CODE
150
EXPLANATION OF TRANSACTION
TAX RETURN FILED
9999-999-99999-9
806
TRANSACTIONS
CYCLE
20111808
Apr. 15, 2011
April 04, 2011
DATE
04-04-2011
AMOUNT
$14,401.00
W-2 or 1099 withholding
04-15-2011
-$13,001.00
766
Credit to your account
04-15-2011
-$762.00
766
Credit to your account
04-15-2011
-$2,000.00
846
Refund issued
05-16-2011
$1,362.00
This Product Contains Sensitive Taxpayer Data
9
Requesting Tax Transcripts
There are several ways tax filers can request a tax transcript, most of which do not involve payment of a fee to the IRS.
Some methods take longer for processing than others. In Dear Colleague Letter GEN-11-13, ED recommended three
methods in particular.
Tax Transcript Output Document
Request Method
Where?
What?
How?
When?
Direct to Third
Party?
Online
www.irs.gov
Paper
Mailed
5-10 days
No
Telephone
(800) 908-9946
Paper
Mailed
5-10 days
No
www.irs.gov/pub/irs
-pdf/f4506tez.pdf
Paper
Mailed
5-10 days
Yes
IRS Form 4506T-EZ
Online Request
On the IRS website in the “Online Services” section, tax filers can “Order a Tax Return or Account Transcript.” The tax filer
enters the Social Security number, date of birth and address as it appears on the most recent tax return filed with the IRS,
and clicks the “Continue” button.
It might be helpful to recommend to students and parents to have a copy of the most recent federal income tax return on
hand when completing a request for an IRS tax transcript.
NOTES
10
In the “Type of Transcript” field, the tax filer chooses “Return Transcript” or “Account Transcript” and selects the appropriate
tax year.
A confirmation message appears and the tax filer is given the opportunity to request another transcript, if needed.
A paper copy of the IRS tax transcript should arrive in the mail within five to 10 days. Transcripts ordered using this
method cannot be sent to a third party, such as an office at a college or university, only to the tax filer at the address
associated with this request.
NOTES
11
Automated Telephone Request
Signature Requirements
The tax filer can call the IRS and follow the prompts to
enter the Social Security number and numbers of the street
address as it appears on the most recent tax return filed
with the IRS. The caller selects “Option 2” to request the
transcript and the appropriate year.
Dear Colleague Letter GEN-11-13.
For the 2011-2012 award year, IRS tax transcripts must be
signed by at least one of the tax filers identified on the
record as a tax filer. An exception to this requirement may
be made if the school can document receipt directly from
the IRS. For example, a copy of an IRS tax transcript
obtained by the tax filer must be signed somewhere on the
document before providing it to the school. On the other
hand, if the tax filer authorized delivery of the transcript by
the IRS directly to the school, and the school retains the
envelope in which the document arrived, the tax filer’s
signature on the tax transcript is not required.
A paper copy of the IRS tax transcript should arrive in the
mail within five to 10 days. Transcripts ordered using this
method cannot be sent directly to a third party, only to the
tax filer at the address associated with this request.
Paper Request Form
IRS Form 4506T-EZ can be downloaded from the IRS
website, completed, and mailed or faxed to the IRS at the
appropriate address or fax number as listed on the form.
The address on line three should match the most recent
address on file with the IRS. The appropriate tax year
should be indicated on line six. The tax filer — or the tax
filer’s spouse, if a joint return was filed — must sign and
date the form and provide a telephone number.
ED has indicated that the expectation for the 2012-2013
award year will be different. In GEN-11-13, ED stated that
collecting signatures on IRS tax transcripts submitted for
verification purposes is encouraged, but not required.
A paper copy of the IRS tax transcript should arrive in the
mail within five to 10 days from the date the IRS receives
the form. Transcripts ordered using this method can be
mailed directly to a third party by the IRS, as indicated by
the tax filer on line five.
NOTES
12
Comparison of Tax Return and Tax Transcript Data
FAFSA instructions direct applicants to obtain information from certain lines on IRS income tax returns, which differ based
on whether the tax filer completed a Form 1040, 1040A or 1040EZ. For the most part, the instructions are able to identify
the relevant lines on the tax return by line number. These line item numbers do not appear on IRS tax transcripts. Instead,
each item is identified by name. When verifying FAFSA data using tax transcripts, it is important to identify the
correct answer for comparison.
The following pages contain sample tax returns for Sam Lee (IRS Form 1040-EZ), Cam Larson (IRS Form 1040-A), and
Michael and Brooke Davis (IRS Form 1040), as well as sample IRS Tax Return Transcripts for these tax filers. Relevant line
items have been highlighted as follows:
Red: information to help cross-reference tax return line items with corresponding data on the tax return transcript.
Yellow: tax return line items that are required verification data elements for the 2012-2013 award year.
Blue: tax return line items listed in the FAFSA instructions, which should be reviewed for potential conflicting
information.
NOTES
13
Sample IRS Form 1040EZ: Sam Lee
Department of the Treasury—Internal Revenue Service
Income Tax Return for Single and
Joint Filers With No Dependents (99)
Form
1040EZ
Your first name and initial
2011
OMB No. 1545-0074
Your social security number
Last name
Sam R
Lee
If a joint return, spouse’s first name and initial
AAA AA AAAA
Spouse’s social security number
Last name
Apt. no.
Home address (number and street). If you have a P.O. box, see instructions.
123 Broken Arrow
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Presidential Election Campaign
Anaheim, CA 92804
Foreign country name
Wages, salaries, and tips. This should be shown in box 1 of your Form(s) W-2.
Attach your Form(s) W-2.
1
2
Taxable interest. If the total is over $1,500, you cannot use Form 1040EZ.
2
3
Unemployment compensation and Alaska Permanent Fund dividends (see instructions).
3
4
5
Add lines 1, 2, and 3. This is your adjusted gross income.
If someone can claim you (or your spouse if a joint return) as a dependent, check
the applicable box(es) below and enter the amount from the worksheet on back.
4
6,381 00
5
5,800 00
Income
1
Attach
Form(s) W-2
here.
6
7
8a
b
9
10
Payments,
Credits,
and Tax
11a
Refund
Have it directly
deposited! See
instructions and
fill in 11b, 11c,
and 11d or
Form 8888.
F
Paid
Preparer
Use Only
Routing number
a
d
Account number
ac
6
7
8a
581 00
350 00
a
9
350 00
10
59 00
Type:
Phone
no.
Checking
Savings
a
12
Yes. Complete below.
Personal identification
number (PIN)
a
291 00
11a
If line 10 is larger than line 9, subtract line 9 from line 10. This is
the amount you owe. For details on how to pay, see instructions.
Designee’s
a
name
Sign
Here
Keep a copy for
your records.
b
6,381 00
a
If line 9 is larger than line 10, subtract line 10 from line 9. This is your refund.
If Form 8888 is attached, check here a
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Third Party
Designee
Joint return? See
instructions.
You
Spouse
If no one can claim you (or your spouse if a joint return), enter $9,500 if single;
$19,000 if married filing jointly. See back for explanation.
Subtract line 5 from line 4. If line 5 is larger than line 4, enter -0-.
This is your taxable income.
Federal income tax withheld from Form(s) W-2 and 1099.
Earned income credit (EIC) (see instructions).
Nontaxable combat pay election.
8b
Add lines 7 and 8a. These are your total payments and credits.
Tax. Use the amount on line 6 above to find your tax in the tax table in the
instructions. Then, enter the tax from the table on this line.
a
12
Amount
You Owe
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign postal code a box below will not change your tax or
refund.
You
Spouse
Foreign province/county
Enclose, but do
not attach, any
payment.
Make sure the SSN(s)
above are correct.
c
No
a
Under penalties of perjury, I declare that I have examined this return and, to the best of my knowledge and belief, it is true, correct, and
accurately lists all amounts and sources of income I received during the tax year. Declaration of preparer (other than the taxpayer) is based
on all information of which the preparer has any knowledge.
Daytime phone number
Your occupation
Your signature
Date
Spouse’s signature. If a joint return, both must sign.
Print/Type preparer’s name
Firm’s name
2/24/12
Student
(555) 123-4567
Date
Spouse’s occupation
If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
PTIN
Check
if
self-employed
Preparer’s signature
Date
a
Firm's EIN
Firm’s address a
Phone no.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions.
14
a
Cat. No. 11329W
Form 1040EZ (2011)
Page 2
Form 1040EZ (2011)
Use this form
if
• Your filing status is single or married filing jointly. If you are not sure about your filing status, see instructions.
• You (and your spouse if married filing jointly) were under age 65 and not blind at the end of 2011. If you were born on
January 1, 1947, you are considered to be age 65 at the end of 2011.
• You do not claim any dependents. For information on dependents, see Pub. 501.
• Your taxable income (line 6) is less than $100,000.
• You do not claim any adjustments to income. For information on adjustments to income, use TeleTax topics 451–453 and
455–458 (see instructions).
• The only tax credit you can claim is the earned income credit (EIC). The credit may give you a refund even if you do not owe
any tax. You do not need a qualifying child to claim the EIC. For information on credits, use TeleTax topics 601, 602, 607,
608, 610, 611, and 612 (see instructions).
• You had only wages, salaries, tips, taxable scholarship or fellowship grants, unemployment compensation, or Alaska
Permanent Fund dividends, and your taxable interest was not over $1,500. But if you earned tips, including allocated tips, that
are not included in box 5 and box 7 of your Form W-2, you may not be able to use Form 1040EZ (see instructions). If you are
planning to use Form 1040EZ for a child who received Alaska Permanent Fund dividends, see instructions.
Filling in your
return
If you received a scholarship or fellowship grant or tax-exempt interest income, such as on municipal bonds, see the
instructions before filling in the form. Also, see the instructions if you received a Form 1099-INT showing federal income tax
withheld or if federal income tax was withheld from your unemployment compensation or Alaska Permanent Fund dividends.
For tips on
how to avoid
common
mistakes, see
instructions.
Remember, you must report all wages, salaries, and tips even if you do not get a Form W-2 from your employer. You must also
report all your taxable interest, including interest from banks, savings and loans, credit unions, etc., even if you do not get a
Form 1099-INT.
Worksheet
for Line 5 —
Dependents
Who Checked
One or Both
Boxes
Use this worksheet to figure the amount to enter on line 5 if someone can claim you (or your spouse if married
filing jointly) as a dependent, even if that person chooses not to do so. To find out if someone can claim you as a
dependent, see Pub. 501.
(keep a copy for
your records)
Mailing
Return
A. Amount, if any, from line 1 on front .
.
.
.
.
6,381.00
.
+
300.00 Enter total a
B. Minimum standard deduction . . . . . . . . . . . . . . . . . . . .
C. Enter the larger of line A or line B here . . . . . . . . . . . . . . . . .
D. Maximum standard deduction. If single, enter $5,800; if married filing jointly, enter $11,600
E. Enter the smaller of line C or line D here. This is your standard deduction . . . . . . .
F. Exemption amount.
• If single, enter -0-.
• If married filing jointly and —
—both you and your spouse can be claimed as dependents, enter -0-.
—only one of you can be claimed as a dependent, enter $3,700.
G. Add lines E and F. Enter the total here and on line 5 on the front
. . . . . . . . .
A.
B.
C.
D.
E.
6,681.00
950.00
6,681.00
5,800.00
5,800.00
F.
0.00
. G.
5,800.00
.
.
.
.
}
If you did not check any boxes on line 5, enter on line 5 the amount shown below that applies to you.
• Single, enter $9,500. This is the total of your standard deduction ($5,800) and your exemption ($3,700).
• Married filing jointly, enter $19,000. This is the total of your standard deduction ($11,600), your exemption ($3,700), and
your spouse's exemption ($3,700).
Mail your return by April 17, 2012. Mail it to the address shown on the last page of the instructions.
Form 1040EZ (2011)
15
Sample Tax Transcript 1040EZ: Sam Lee
This Product Contains Sensitive Taxpayer Data
Request Date: 03-15-2012
Response Date: 03-15-2012
Tracking Number: XXXXXXXXXXXX
Tax Return Transcript
SSN Provided: AAA-AA-AAAA
Tax Period Ending: Dec. 31, 2011
The following items reflect the amount as shown on the return (PR), and the amount as
adjusted (PC), if applicable. They do not show subsequent activity on the account.
SSN: AAA-AA-AAAA
SPOUSE SSN:
NAME(S) SHOWN ON RETURN:
SAM R LEE
ADDRESS: 123 BROKEN ARROW
ANAHEIM, CA 92804
5
FILING STATUS:
FORM NUMBER:
CYCLE POSTED:
RECEIVED DATE:
REMITTANCE:
EXEMPTION NUMBER:
IDENTITY THEFT PERSONAL ID NUMBER:
PREPARER SSN:
PREPARER EIN:
Single
1040EZ
20121102
Apr. 15, 2012
$0.00
0
000000
Income
1
WAGES, SALARIES, TIPS, ETC:................................................. $6,381.00
TAXABLE INTEREST INCOME:....................................................... $0.00
TAX-EXEMPT INTEREST:........................................................... $0.00
UNEMPLOYMENT COMPENSATION:..................................................... $0.00
Adjustments to Income
4
ADJUSTED GROSS INCOME:...................................................... $6,381.00
ADJUSTED GROSS INCOME PER COMPUTER:......................................... $6,381.00
DEPENDENT ON ANOTHER TP:.......................................................... YES
FORM 1040EZ DEDUCTION AND EXEMPTION PER COMPUTER:.............................. $0.00
Tax and Credits
TAXABLE INCOME:............................................................... $581.00
TAXABLE INCOME PER COMPUTER:.................................................. $581.00
Other Taxes
TOTAL TAX LIABILITY TP FIGURES:............................................... $59.00
10 TOTAL TAX LIABILITY TP FIGURES PER COMPUTER:.................................. $59.00
Payments
FEDERAL INCOME TAX WITHHELD:.................................................. $350.00
MAKING WORK PAY AND GOV’T RET CREDIT:.......................................... $0.00
MAKING WORK PAY AND GOV’T RET CREDIT PER COMPUTER:............................. $0.00
MAKING WORK PAY AND GOV’T RET CREDIT VERIFIED:................................. $0.00
EARNED INCOME CREDIT:.......................................................... $0.00
EARNED INCOME CREDIT PER COMPUTER:............................................. $0.00
EARNED INCOME CREDIT NONTAXABLE COMBAT PAY:.................................... $0.00
SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER:.................................. $0.00
TOTAL PAYMENTS:............................................................... $350.00
TOTAL PAYMENTS PER COMPUTER:.................................................. $350.00
16
Tracking Number: XXXXXXXXXXXX
Refund or Amount Owed
REFUND AMOUNT:............................................................... $-291.00
BAL DUE/OVER PYMT USING TP FIG PER COMPUTER:................................. $-291.00
BAL DUE/OVER PYMT USING COMPUTER FIGURES:.................................... $-291.00
FORM 8888 TOTAL REFUND PER COMPUTER:............................................ $0.00
Third Party Designee
THIRD PARTY DESIGNEE ID NUMBER:.......................................................
AUTHORIZATION INDICATOR:............................................................ 0
THIRD PARTY DESIGNEE NAME:............................................................
This Product Contains Sensitive Taxpayer Data
17
Sample IRS Form 1040A: Cam E. Larson
Form
Department of the Treasury—Internal Revenue Service
1040A
U.S. Individual Income Tax Return (99)
Your first name and initial
2011
IRS Use Only—Do not write or staple in this space.
Last name
OMB No. 1545-0074
Your social security number
Cam E.
Larson
If a joint return, spouse’s first name and initial
Last name
GGG GG GGGG
Spouse’s social security number
Home address (number and street). If you have a P.O. box, see instructions.
Apt. no.
456 Center Street
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Fullerton, CA 92883
Foreign country name
Filing
status
Check only
one box.
Exemptions
c
Make sure the SSN(s) above
and on line 6c are correct.
Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign postal code a box below will not change your tax or
refund.
You
Spouse
Foreign province/county
1
2
3
4
Single
Head of household (with qualifying person). (See instructions.)
Married filing jointly (even if only one had income)
If the qualifying person is a child but not your dependent,
enter this child’s name here. a
Married filing separately. Enter spouse’s SSN above and
5
Qualifying widow(er) with dependent child (see instructions)
full name here. a
Boxes
6a
Yourself. If someone can claim you as a dependent, do not check
checked on
1
box 6a.
6a and 6b
No. of children
b
Spouse
on 6c who:
(4) if child under
c Dependents:
• lived with
(3) Dependent’s
}
(2) Dependent’s social
security number
If more than six
dependents, see
instructions.
(1) First name
relationship to you
Last name
age 17 qualifying for
child tax credit (see
instructions)
you
• did not live
with you due to
divorce or
separation (see
instructions)
Dependents
on 6c not
entered above
Add numbers
on lines
above a
d Total number of exemptions claimed.
Income
7
Attach
Form(s) W-2
here. Also
attach
Form(s)
1099-R if tax
was
withheld.
If you did not
get a W-2, see
instructions.
Enclose, but do
not attach, any
payment. Also,
please use Form
1040-V.
Adjusted
gross
income
Wages, salaries, tips, etc. Attach Form(s) W-2.
7
8a
b
9a
b
10
11a
Taxable interest. Attach Schedule B if required.
Tax-exempt interest. Do not include on line 8a. 8b
Ordinary dividends. Attach Schedule B if required.
Qualified dividends (see instructions).
9b
Capital gain distributions (see instructions).
IRA
11b Taxable amount
distributions.
11a
(see instructions).
12a Pensions and
12b Taxable amount
annuities.
12a
(see instructions).
Add lines 7 through 14b (far right column). This is your total income.
16
17
18
Educator expenses (see instructions).
IRA deduction (see instructions).
Student loan interest deduction (see instructions).
19
20
Tuition and fees. Attach Form 8917.
19
Add lines 16 through 19. These are your total adjustments.
21
Subtract line 20 from line 15. This is your adjusted gross income.
16
17
18
9a
10
11b
12b
13
14b
a
15
22,058 00
20
2,500 00
2,500 00
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
18
22,058 00
8a
13 Unemployment compensation and Alaska Permanent Fund dividends.
14a Social security
14b Taxable amount
benefits.
14a
(see instructions).
15
1
a
21
Cat. No. 11327A
19,558 00
Form 1040A (2011)
Page 2
Form 1040A (2011)
Tax, credits, 22 Enter the amount from line 21 (adjusted gross income).
You were born before January 2, 1947,
Blind Total boxes
23a Check
and
if:
Spouse
was
born
before
January
2,
1947,
Blind checked a 23a
payments
{
Standard
Deduction
for—
• People who
check any
box on line
23a or 23b or
who can be
claimed as a
dependent,
see
instructions.
• All others:
Single or
Married filing
separately,
$5,800
Married filing
jointly or
Qualifying
widow(er),
$11,600
Head of
household,
$8,500
If you have
a qualifying
child, attach
Schedule
EIC.
Refund
Direct
deposit?
See
instructions
and fill in
43b, 43c,
and 43d or
Form 8888.
Amount
you owe
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Sign
here
Paid
preparer
use only
F
Joint return?
See page 13.
Keep a copy
for your
records.
19,558 00
24
25
26
5,800 00
13,758 00
3,700 00
27
28
10,058 00
1,086 00
34
1,000 00
35
86 00
41
2,229 00
42
43a
2,143 00
2,143 00
}
b If you are married filing separately and your spouse itemizes
a 23b
deductions, check here
24 Enter your standard deduction.
25 Subtract line 24 from line 22. If line 24 is more than line 22, enter -0-.
26 Exemptions. Multiply $3,700 by the number on line 6d.
27 Subtract line 26 from line 25. If line 26 is more than line 25, enter -0-.
a
This is your taxable income.
28 Tax, including any alternative minimum tax (see instructions).
29 Credit for child and dependent care expenses. Attach
Form 2441.
29
30 Credit for the elderly or the disabled. Attach
Schedule R.
30
31 Education credits from Form 8863, line 23.
31
1,000 00
32 Retirement savings contributions credit. Attach
Form 8880.
32
33 Child tax credit (see instructions).
33
34 Add lines 29 through 33. These are your total credits.
35 Subtract line 34 from line 28. If line 34 is more than line 28, enter -0-. This is
your total tax.
36 Federal income tax withheld from Forms W-2 and
1099.
36
2,229 00
37 2011 estimated tax payments and amount applied
from 2010 return.
37
38a Earned income credit (EIC).
38a
b Nontaxable combat pay
election.
38b
39 Additional child tax credit. Attach Form 8812.
39
40 American opportunity credit from Form 8863, line 14.
40
a
41 Add lines 36, 37, 38a, 39, and 40. These are your total payments.
42 If line 41 is more than line 35, subtract line 35 from line 41.
This is the amount you overpaid.
43a Amount of line 42 you want refunded to you. If Form 8888 is attached, check here a
Routing
a c Type:
Checking
Savings
a b
number X X X X X X X X X
Account
a d
number X X X X X X X X X X X X X X X X X
44 Amount of line 42 you want applied to your
2012 estimated tax.
44
45 Amount you owe. Subtract line 41 from line 35. For details on how to pay,
a
see instructions.
46 Estimated tax penalty (see instructions).
46
Third party
designee
22
45
Yes. Complete the following.
No
Designee’s
Phone
Personal identification
a
a
a
no.
number (PIN)
name
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and accurately list all amounts and sources of income I received during the tax year. Declaration of preparer (other
than the taxpayer) is based on all information of which the preparer has any knowledge.
Your occupation
Daytime phone number
Your signature
Date
Spouse’s signature. If a joint return, both must sign.
Print/type preparer's name
1/27/12
Lighting Technician
Date
Spouse’s occupation
Preparer’s signature
Date
(555) 456-7891
If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
PTIN
Check a
if
self-employed
Firm's name a
Firm's EIN a
Firm's address a
Phone no.
Form 1040A (2011)
19
Sample Tax Transcript 1040A: Cam E. Larson
This Product Contains Sensitive Taxpayer Data
Request Date: 02-24-2012
Response Date: 02-24-2012
Tracking Number: XXXXXXXXXXXX
Tax Return Transcript
SSN Provided: GGG-GG-GGGG
Tax Period Ending: Dec. 31, 2011
The following items reflect the amount as shown on the return (PR), and the
amount as adjusted (PC), if applicable. They do not show subsequent activity
on the account.
SSN:
SPOUSE SSN:
GGG-GG-GGGG
NAME(S) SHOWN ON RETURN: Cam E. Larson
ADDRESS: 456 CENTER STREET
FULLERTON, CA 92833
6d
FILING STATUS:
FORM NUMBER:
CYCLE POSTED:
RECEIVED DATE:
REMITTANCE:
EXEMPTION NUMBER:
DEPENDENT 1 NAME CTRL:
DEPENDENT 1 SSN:
DEPENDENT 2 NAME CTRL:
DEPENDENT 2 SSN:
DEPENDENT 3 NAME CTRL:
DEPENDENT 3 SSN:
DEPENDENT 4 NAME CTRL:
DEPENDENT 4 SSN:
IDENTITY THEFT PERSONAL ID NUMBER:
PREPARER SSN:
PREPARER EIN:
SINGLE
1040A
20120905
Apr. 15, 2012
$0.00
1
000000
XXXXX
XX-XXXX
Income
7
8b
11a-11b
12a-12b
WAGES, SALARIES, TIPS, ETC:..........................................$22,058.00
TAXABLE INTEREST INCOME:..................................................$0.00
TAX-EXEMPT INTEREST:......................................................$0.00
ORDINARY DIVIDEND INCOME: SCH B:..........................................$0.00
QUALIFIED DIVIDENDS:......................................................$0.00
CAPITAL GAIN OR LOSS: SCHEDULE D:.........................................$0.00
CAPITAL GAINS OR LOSS: SCHEDULE D PER COMPUTER:...........................$0.00
TOTAL IRA DISTRIBUTIONS:..................................................$0.00
TAXABLE IRA DISTRIBUTIONS:................................................$0.00
TOTAL PENSIONS AND ANNUITIES:.............................................$0.00
TAXABLE PENSION/ANNUITY AMOUNT:...........................................$0.00
UNEMPLOYMENT COMPENSATION:................................................$0.00
TOTAL SOCIAL SECURITY BENEFITS:...........................................$0.00
TAXABLE SOCIAL SECURITY BENEFITS:.........................................$0.00
TAXABLE SOCIAL SECURITY BENEFITS PER COMPUTER:............................$0.00
SCH EIC DISQUALIFIED INC COMPUTER:........................................$0.00
TOTAL INCOME:........................................................$22,058.00
TOTAL INCOME PER COMPUTER:...........................................$22,058.00
Adjustments to Income
17
EDUCATOR EXPENSES:........................................................$0.00
EDUCATOR EXPENSES PER COMPUTER:...........................................$0.00
EARLY WITHDRAWAL OF SAVINGS PENALTY:......................................$0.00
IRA DEDUCTION:............................................................$0.00
IRA DEDUCTION PER COMPUTER:...............................................$0.00
20
Tracking Number:
21
XXXXXXXXX
STUDENT LOAN INTEREST DEDUCTION:......................................$2,500.00
STUDENT LOAN INTEREST DEDUCTION PER COMPUTER:.........................$2,500.00
TUITION AND FEES DEDUCTION:...............................................$0.00
TUITION AND FEES DEDUCTION PER COMPUTER:..................................$0.00
JURY DUTY PAY DEDUCTION:..................................................$0.00
TOTAL ADJUSTMENTS:....................................................$2,500.00
TOTAL ADJUSTMENTS PER COMPUTER:.......................................$2,500.00
ADJUSTED GROSS INCOME:...............................................$19,558.00
ADJUSTED GROSS INCOME PER COMPUTER:..................................$19,558.00
Tax and Credits
31
35
65-OR-OVER:...................................................................0
BLIND:........................................................................0
SPOUSE 65-OR-OVER:............................................................0
SPOUSE BLIND:.................................................................0
EXEMPTION AMOUNT PER COMPUTER:........................................$3,700.00
TAXABLE INCOME:......................................................$10,058.00
TAXABLE INCOME PER COMPUTER:.........................................$10,058.00
TENTATIVE TAX:........................................................$1,086.00
TENTATIVE TAX PER COMPUTER:...........................................$1,086.00
CHILD & DEPENDENT CARE CREDIT:............................................$0.00
CHILD & DEPENDENT CARE CREDIT PER COMPUTER:...............................$0.00
CREDIT FOR ELDERLY AND DISABLED:..........................................$0.00
CREDIT FOR ELDERLY AND DISABLED PER COMPUTER:.............................$0.00
EDUCATION CREDIT:.....................................................$1,000.00
EDUCATION CREDIT PER COMPUTER:........................................$1,000.00
GROSS EDUCATION CREDIT PER COMPUTER:......................................$0.00
RETIREMENT SAVINGS CNTRB CREDIT:..........................................$0.00
RETIREMENT SAVINGS CNTRB CREDIT PER COMPUTER:.............................$0.00
PRIM RET SAV CNTRB: F8880 LN6A:...........................................$0.00
SEC RET SAV CNTRB: F8880 LN6B:............................................$0.00
CHILD TAX CREDIT:.........................................................$0.00
CHILD TAX CREDIT PER COMPUTER:............................................$0.00
ADOPTION CREDIT: F8839:...................................................$0.00
ADOPTION CREDIT PER COMPUTER:.............................................$0.00
TOTAL CREDITS:........................................................$1,000.00
TOTAL CREDITS PER COMPUTER:...........................................$1,000.00
Other Taxes
ADVANCED EARNED INCOME CREDIT:............................................$0.00
TOTAL TAX LIABILITY TP FIGURES:..........................................$86.00
TOTAL TAX LIABILITY TP FIGURES PER COMPUTER:.............................$86.00
Payments
FEDERAL INCOME TAX WITHHELD:..........................................$2.229.00
ESTIMATED TAX PAYMENTS:...................................................$0.00
MAKING WORK PAY AND GOV’T RET CREDIT:.....................................$0.00
MAKING WORK PAY AND GOV’T RET CREDIT PER COMPUTER:........................$0.00
MAKING WORK PAY AND GOV’T RET CREDIT VERIFIED:............................$0.00
REFUNDABLE EDUCATION CREDIT:..............................................$0.00
REFUNDABLE EDUCATION CREDIT PER COMPUTER:.................................$0.00
REFUNDABLE EDUCATION CREDIT VERIFIED:.....................................$0.00
EARNED INCOME CREDIT:.....................................................$0.00
EARNED INCOME CREDIT PER COMPUTER:........................................$0.00
EARNED INCOME CREDIT NONTAXABLE COMBAT PAY:...............................$0.00
SCHEDULE M NONTAXABLE COMBAT PAY:.........................................$0.00
FORM 8812 NONTAXABLE COMBAT PAY:..........................................$0.00
TOT SS/MEDICARE WITHHELD: F8812:..........................................$0.00
FORM 8812 ADDITIONAL CHILD TAX CREDIT:....................................$0.00
FORM 8812 ADDITIONAL CHILD TAX CREDIT PER COMPUTER:.......................$0.00
FORM 8812 ADDITIONAL CHILD TAX CREDIT VERIFED:............................$0.00
SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER:.............................$0.00
TOTAL PAYMENTS:.......................................................$2,229.00
TOTAL PAYMENTS PER COMPUTER:..........................................$2,229.00
21
Tracking Number:
XXXXXXXXXXXX
Refund or Amount Owed
REFUND AMOUNT:.......................................................$-2,143.00
APPLIED TO NEXT YEAR’S ESTIMATED TAX:.....................................$0.00
ESTIMATED TAX PENALTY:....................................................$0.00
BAL DUE/OVER PYMT USING TP FIG PER COMPUTER:.........................$-2,143.00
BAL DUE/OVER PYMT USING COMPUTER FIGURES:............................$-2,143.00
FORM 8888 TOTAL REFUND PER COMPUTER:......................................$0.00
Third Party Designee
THIRD PARTY DESIGNEE ID NUMBER:................................................
AUTHORIZATION INDICATOR:......................................................0
THIRD PARTY DESIGNEE NAME:.....................................................
Form 8863 – Education Credits (Hope and Lifetime Learning Credits)
PART III – ALLOWABLE EDUCATION CREDITS
GROSS EDUCATION CR PER COMPUTER:......................................$1,000.00
TOTAL EDUCATION CREDIT AMOUNT:........................................$1,000.00
GROSS EDUCATION CREDIT AMOUNT PER COMPUTER:...........................$1,000.00
This Product Contains Sensitive Taxpayer Data
22
Form
Sample IRS Form 1040: Michael and Brooke Davis
1040
(99)
Department of the Treasury—Internal Revenue Service
2011
U.S. Individual Income Tax Return
For the year Jan. 1–Dec. 31, 2011, or other tax year beginning
OMB No. 1545-0074
, 2011, ending
Your first name and initial
Last name
Michael C.
Davis
If a joint return, spouse’s first name and initial
Last name
Brooke B.
Davis
IRS Use Only—Do not write or staple in this space.
See separate instructions.
, 20
Your social security number
BBB BB BBBB
Spouse’s social security number
CCC CC CCCC
Apt. no.
Home address (number and street). If you have a P.O. box, see instructions.
c
123 Main Street
City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions).
Presidential Election Campaign
Springfield, OR 97477
Foreign country name
Filing Status
Check only one
box.
Exemptions
Single
Married filing jointly (even if only one had income)
2
3
6a
c
Spouse
.
Dependents:
If you did not
get a W-2,
see instructions.
Enclose, but do
not attach, any
payment. Also,
please use
Form 1040-V.
Adjusted
Gross
Income
.
.
.
.
.
the qualifying person is a child but not your dependent, enter this
.
.
.
.
.
.
(2) Dependent’s
social security number
Last name
Jack Franklin Davis
child’s name here. a
5
Qualifying widow(er) with dependent child
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
}
(4) if child under age 17
qualifying for child tax credit
(see instructions)
(3) Dependent’s
relationship to you
Boxes checked
on 6a and 6b
No. of children
on 6c who:
• lived with you
2
1
• did not live with
you due to divorce
or separation
(see instructions)
DDD DD DDDD Son
Dependents on 6c
not entered above
d
Attach Form(s)
W-2 here. Also
attach Forms
W-2G and
1099-R if tax
was withheld.
Head of household (with qualifying person). (See instructions.) If
Yourself. If someone can claim you as a dependent, do not check box 6a .
(1) First name
Income
4
Married filing separately. Enter spouse’s SSN above
and full name here. a
b
If more than four
dependents, see
instructions and
check here a
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
Foreign postal code
a box below will not change your tax or
refund.
You
Spouse
Foreign province/county
1
Make sure the SSN(s) above
and on line 6c are correct.
.
.
.
.
.
.
.
.
.
.
8b
. .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
8a
.
.
.
.
.
.
.
9a
10
11
Qualified dividends . . . . . . . . . . .
9b
Taxable refunds, credits, or offsets of state and local income taxes
Alimony received . . . . . . . . . . . . . . .
.
.
.
.
.
.
.
.
.
.
.
.
10
11
12
13
14
Business income or (loss). Attach Schedule C or C-EZ . . . . . . . . .
Capital gain or (loss). Attach Schedule D if required. If not required, check here a
Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . .
.
12
13
14
15a
16a
17
IRA distributions .
15a
b Taxable amount
. . .
Pensions and annuities 16a
b Taxable amount
. . .
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E
15b
16b
17
18
19
20a
Farm income or (loss). Attach Schedule F .
Unemployment compensation . . . .
Social security benefits 20a
18
19
20b
21
22
Other income. List type and amount
Combine the amounts in the far right column for lines 7 through 21. This is your total income
23
Educator expenses
24
Certain business expenses of reservists, performing artists, and
fee-basis government officials. Attach Form 2106 or 2106-EZ
25
Health savings account deduction. Attach Form 8889
.
24
25
26
27
28
Moving expenses. Attach Form 3903 . . . . . .
Deductible part of self-employment tax. Attach Schedule SE .
Self-employed SEP, SIMPLE, and qualified plans
. .
26
27
28
29
30
31a
Self-employed health insurance deduction
Penalty on early withdrawal of savings . .
.
.
.
.
.
.
.
.
32
33
34
Alimony paid b Recipient’s SSN a
IRA deduction . . . . . . .
Student loan interest deduction . .
Tuition and fees. Attach Form 8917 .
29
30
31a
.
.
.
.
.
.
.
.
.
.
.
.
32
33
34
35
36
37
Domestic production activities deduction. Attach Form 8903
35
Add lines 23 through 35 . . . . . . . . . . . . .
Subtract line 36 from line 22. This is your adjusted gross income
7
8a
b
9a
b
Total number of exemptions claimed
.
.
.
.
Wages, salaries, tips, etc. Attach Form(s) W-2
.
Taxable interest. Attach Schedule B if required .
Tax-exempt interest. Do not include on line 8a .
Ordinary dividends. Attach Schedule B if required
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. . . . . .
. . . . . .
b Taxable amount
.
.
.
.
.
.
a
.
7
21
22
Add numbers on
lines above a
3
29,440 00
29,440 00
23
.
.
For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
24
.
.
.
.
.
.
.
.
.
.
.
.
.
.
a
36
37
Cat. No. 11320B
11,440
29,440 00
Form
1040
(2011)
Page 2
Form 1040 (2011)
Tax and
Credits
Standard
Deduction
for—
• People who
check any
box on line
39a or 39b or
who can be
claimed as a
dependent,
see
instructions.
• All others:
Single or
Married filing
separately,
$5,800
Married filing
jointly or
Qualifying
widow(er),
$11,600
Head of
household,
$8,500
Other
Taxes
38
Amount from line 37 (adjusted gross income)
39a
Check
if:
Blind.
Blind.
.
}
.
.
.
.
.
.
44
45
46
Alternative minimum tax (see instructions). Attach Form 6251 .
Add lines 44 and 45 . . . . . . . . . . . . . .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
47
48
Foreign tax credit. Attach Form 1116 if required .
Credit for child and dependent care expenses. Attach Form 2441
47
48
49
50
51
Education credits from Form 8863, line 23 . . . . .
Retirement savings contributions credit. Attach Form 8880
Child tax credit (see instructions) . . . . . . . .
49
50
51
52
53
54
55
Residential energy credits. Attach Form 5695 . . . .
52
3800 b
8801 c
Other credits from Form: a
53
Add lines 47 through 53. These are your total credits . . . . .
Subtract line 54 from line 46. If line 54 is more than line 46, enter -0-
56
57
Self-employment tax. Attach Schedule SE . . . .
Unreported social security and Medicare tax from Form:
58
59a
b
Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required
Household employment taxes from Schedule H
. . . .
a
4137
.
.
.
.
.
a
.
.
.
.
.
.
.
.
b
.
.
.
.
.
.
.
.
. .
8919
.
.
.
.
.
.
.
.
.
.
.
.
.
First-time homebuyer credit repayment. Attach Form 5405 if required
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
Federal income tax withheld from Forms W-2 and 1099 . .
2011 estimated tax payments and amount applied from 2010 return
64a
b
65
66
Earned income credit (EIC) . . . .
Nontaxable combat pay election
64b
Additional child tax credit. Attach Form 8812
.
.
.
.
.
.
.
.
.
American opportunity credit from Form 8863, line 14 .
First-time homebuyer credit from Form 5405, line 10 .
Amount paid with request for extension to file . . .
.
.
.
.
.
.
.
.
.
.
a
62
63
64a
2,756 00
43
44
45
46
00
00
00
00
00
00
00
673 00
0 00
55
56
57
65
66
327 00
60
61
0 00
1,871 00
67
68
. . . .
69
Credit for federal tax on fuels. Attach Form 4136 . . . .
70
Credits from Form: a
2439 b
8839 c
8801 d
8885 71
Add lines 62, 63, 64a, and 65 through 71. These are your total payments .
Excess social security and tier 1 RRTA tax withheld
.
.
.
.
a
73
If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid
74a
b
d
Amount of line 73 you want refunded to you. If Form 8888 is attached, check here . a
Routing number
Savings
X X X X X X X X X a c Type: Checking
Account number
X X X X X X X X X X X X X X X X X
Amount of line 73 you want applied to your 2012 estimated tax a 75
Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions a
75
76
77
11,600
17,840
11,100
6,740
673
0
673
58
59a
59b
Other taxes. Enter code(s) from instructions
Add lines 55 through 60. This is your total tax
40
41
42
54
a
.
.
29,440 00
673 00
.
.
38
Total boxes
checked a 39a
Exemptions. Multiply $3,700 by the number on line 6d . . . . . . . . . . . .
Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter -0- . .
Form 4972 c
962 election
Tax (see instructions). Check if any from: a
Form(s) 8814 b
77
Estimated tax penalty (see instructions) . . . . . . .
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Designee’s
name a
Phone
no. a
72
73
74a
4,954 00
4,954 00
4,954 00
76
Yes. Complete below.
No
Personal identification
a
number (PIN)
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,
they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Your signature
F
Paid
Preparer
Use Only
.
42
43
a
Joint return? See
instructions.
Keep a copy for
your records.
You were born before January 2, 1947,
Spouse was born before January 2, 1947,
.
39b
Direct deposit?
See
a
instructions.
Sign
Here
.
.
.
67
68
69
70
71
72
Third Party
Designee
.
If your spouse itemizes on a separate return or you were a dual-status alien, check here a
63
Amount
You Owe
.
Itemized deductions (from Schedule A) or your standard deduction (see left margin)
Subtract line 40 from line 38
. . . . . . . . . . . . . . . . .
b
Payments 62
Refund
.
40
41
60
61
If you have a
qualifying
child, attach
Schedule EIC.
{
.
Spouse’s signature. If a joint return, both must sign.
Date
Your occupation
2/9/12
Retail
Daytime phone number
(555) 765-4151
Date
Spouse’s occupation
If the IRS sent you an Identity Protection
PIN, enter it
here (see inst.)
PTIN
Check
if
self-employed XXXXX
2/19/12 Receptionist
Print/Type preparer’s name
Preparer’s signature
Date
Jason Chang
Firm’s name
a
Firm’s address a
Tax Group, Inc.
Springfield, OR 97477
Firm's EIN
Phone no.
a XX-XXXX
(555) 746-4151
Form 1040 (2011)
25
Sample Tax Transcript 1040: Michael and Brooke Davis
PHILADELPHIA, PA 19255-1498
Tracking ID: XXXXXXXXXXXX
Date of Issue: 2-24-2012
MICHAEL C. DAVIS
123 MAIN STREET
SPRINGFIELD, OR 97477
Tax Period: December, 2011
Information about the Request We Received
In this letter, we’ll report the status of the request we received.
We’ve enclosed the transcript or transcripts that you requested on
February 24, 2012.
A tax return transcript is generally available for the current
processing year and for three prior years. It contains most of the
information from your original return, along with information from
the forms and schedules you filed with it.
The transcript, however, does not contain changes made to the return,
by either you or us, after you filed the return. Such changes could
include your filing an amended return, corrections we make to the
return because we discovered a math mistake, or a payment credited
after you filed the return. The transcript also does not show
refunds.
Information for current tax years is available immediately on our
computer systems.
Delivery time to you depends on how you submit your request and the
delivery method you select to receive the information.
If you have any questions about information contained in the
transcripts or other enclosed information, please call us at the IRS
telephone number listed in your local directory or at 1-800-829-8374.
Sincerely Yours,
Director
Electronic Products & Svs Support
Enclosures:
Return Transcript
26
This Product Contains Sensitive Taxpayer Data
Request Date: 02-24-2012
Response Date: 02-24-2012
Tracking Number: XXXXXXXXXXXX
Tax Return Transcript
SSN Provided: BBB-BB-BBBB
Tax Period Ending: Dec. 31, 2011
The following items reflect the amount as shown on the return (PR), and the
amount as adjusted (PC), if applicable. They do not show subsequent activity on
the account.
SSN: BBB-BB-BBBB
SPOUSE SSN: CCC-CC-CCCC
NAME(S) SHOWN ON RETURN: MICHAEL C & BROOKE B DAVIS
ADDRESS: 123 MAIN STREET
SPRINGFIELD, OR 97477
FILING STATUS:
FORM NUMBER:
CYCLE POSTED:
RECEIVED DATE:
REMITTANCE:
6d EXEMPTION NUMBER:
DEPENDENT 1 NAME CTRL:
DEPENDENT 1 SSN:
DEPENDENT 2 NAME CTRL:
DEPENDENT 2 SSN:
DEPENDENT 3 NAME CTRL:
DEPENDENT 3 SSN:
DEPENDENT 4 NAME CTRL:
DEPENDENT 4 SSN:
IDENTITY THEFT PERSONAL ID NUMBER:
PREPARER SSN:
PREPARER EIN:
Married Filing Joint
1040
20120605
Apr. 15, 2012
$0.00
3
DAVI
DDD-DD-DDDD
000000
XXXXX
XX-XXXX
Income
WAGES, SALARIES, TIPS, ETC:............................................. $29,440.00
TAXABLE INTEREST INCOME: SCH B:.............................................. $0.00
8b TAX-EXEMPT INTEREST:......................................................... $0.00
ORDINARY DIVIDEND INCOME: SCH B:............................................. $0.00
QUALIFIED DIVIDENDS:......................................................... $0.00
REFUNDS OF STATE/LOCAL TAXES:................................................ $0.00
ALIMONY RECEIVED:............................................................ $0.00
BUSINESS INCOME OR LOSS (Schedule C):........................................ $0.00
12 BUSINESS INCOME OR LOSS: SCH C PER COMPUTER:................................. $0.00
CAPITAL GAIN OR LOSS: (Schedule D):.......................................... $0.00
CAPITAL GAINS OR LOSS: SCH D PER COMPUTER:................................... $0.00
OTHER GAINS OR LOSSES: (Form 4797):.......................................... $0.00
TOTAL IRA DISTRIBUTIONS:..................................................... $0.00
15a-15b TAXABLE IRA DISTRIBUTIONS:................................................... $0.00
TOTAL PENSIONS AND ANNUITIES:................................................ $0.00
16a-16b TOTAL PENSION/ANNUITY AMOUNT:................................................ $0.00
RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E):................................ $0.00
RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E) PER COMPUTER:................... $0.00
RENT/ROTALTY INCOME/LOSS PER COMPUTER:....................................... $0.00
ESTATE/TRUST INCOME/LOSS PER COMPUTER:....................................... $0.00
PARTNERSHIP/S-CORP INCOME/LOSS PER COMPUTER:................................. $0.00
FARM INCOME OR LOSS (Schedule F):............................................ $0.00
18 FARM INCOME OR LOSS (Schedule F) PER COMPUTER:............................... $0.00
UNEMPLOYMENT COMPENSATION:................................................... $0.00
TOTAL SOCIAL SECURITY BENEFITS:.............................................. $0.00
7
27
Tracking Number:
XXXXXXXXXXXX
TAXABLE SOCIAL SECURITY BENEFITS:.............................................. $0.00
TAXABLE SOCIAL SECURITY BENEFITS PER COMPUTER:................................. $0.00
OTHER INCOME:.................................................................. $0.00
SCHEDULE EIC SE INCOME PER COMPUTER:........................................... $0.00
SCHEDULE EIC EARNED INCOME PER COMPUTER:.................................. $29,440.00
SCH EIC DISQUALIFIED INC COMPUTER:............................................. $0.00
TOTAL INCOME:............................................................. $29,440.00
TOTAL INCOME PER COMPUTER:................................................ $29,440.00
Adjustments to Income
25*
28
32
37
EDUCATOR EXPENSES:
EDUCATOR EXPENSES PER COMPUTER:................................................ $0.00
RESERVIST AND OTHER BUSINESS EXPENSE:.......................................... $0.00
HEALTH SAVINGS ACCT DEDUCTION:................................................. $0.00
HEALTH SAVINGS ACCT DEDUCTION PER COMPUTER:.................................... $0.00
MOVING EXPENSES: F3903:........................................................ $0.00
SELF EMPLOYMENT TAX DEDUCTION:................................................. $0.00
SELF EMPLOYMENT TAX DEDUCTION PER COMPUTER:.................................... $0.00
KEOGH/SEP CONTRIBUTION DEDUCTION:.............................................. $0.00
SELF-EMP HEALTH INS DEDUCTION:................................................. $0.00
EARLY WITHDRAWAL OF SAVINGS PENALTY:........................................... $0.00
ALIMONY PAID SSN:.............................................................. $0.00
ALIMONY PAID:.................................................................. $0.00
IRA DEDUCTION:................................................................. $0.00
IRA DEDUCTION PER COMPUTER:.................................................... $0.00
STUDENT LOAN INTEREST DEDUCTION:............................................... $0.00
STUDENT LOAN INTEREST DEDUCTION PER COMPUTER:.................................. $0.00
TUITION AND FEES DEDUCTION:.................................................... $0.00
TUITION AND FEES DEDUCTION PER COMPUTER:....................................... $0.00
JURY DUTY PAY DEDUCTION:....................................................... $0.00
DOMESTIC PRODUCTION ACTIVITIES DEDUCTION:...................................... $0.00
OTHER ADJUSTMENTS:............................................................. $0.00
ARCHER MSA DEDUCTION:.......................................................... $0.00
ARCHER MSA DEDUCTION PER COMPUTER:............................................. $0.00
TOTAL ADJUSTMENTS:............................................................. $0.00
TOTAL ADJUSTMENTS PER COMPUTER:................................................ $0.00
ADJUSTED GROSS INCOME:.................................................... $29,440.00
ADJUSTED GROSS INCOME PER COMPUTER:....................................... $29,440.00
Tax and Credits
65-OR-OVER:...................................................................... NO
BLIND:........................................................................... NO
SPOUSE 65-OR-OVER:............................................................... NO
SPOUSE BLIND:.................................................................... NO
STANDARD DEDUCTION PER COMPUTER:.......................................... $11,600.00
ADDITIONAL STANDARD DEDUCTION PER COMPUTER:.................................... $0.00
TAX TABLE INCOME PER COMPUTER:............................................ $17,840.00
EXEMPTION AMOUNT PER COMPUTER:............................................ $11,100.00
TAXABLE INCOME:................................................................ $0.00
TAXABLE INCOME PER COMPUTER:................................................... $0.00
TOTAL POSITIVE INCOME PER COMPUTER:....................................... $29,440.00
TENTATIVE TAX:................................................................. $0.00
TENTATIVE TAX PER COMPUTER:.................................................... $0.00
FORM 8814 ADDITIONAL TAX AMOUNT:............................................... $0.00
TAX ON INCOME LESS SOC SEC INCOME PER COMPUTER:................................ $0.00
FORM 6251 ALTERNATIVE MINIMUM TAX:............................................. $0.00
FORM 6251 ALTERNATIVE MINIMUM TAX PER COMPUTER:................................ $0.00
FOREIGN TAX CREDIT:............................................................ $0.00
FOREIGN TAX CREDIT PER COMPUTER:............................................... $0.00
FOREIGN INCOME EXCLUSION PER COMPUTER:......................................... $0.00
FOREIGN INCOME EXCLUSION TAX PER COMPUTER:..................................... $0.00
CHILD & DEPENDENT CARE CREDIT:................................................. $0.00
CHILD & DEPENDENT CARE CREDIT PER COMPUTER:.................................... $0.00
CREDIT FOR ELDERLY AND DISABLED:............................................... $0.00
CREDIT FOR ELDERLY AND DISABLED PER COMPUTER:.................................. $0.00
EDUCATION CREDIT:.............................................................. $0.00
49 EDUCATION CREDIT PER COMPUTER:................................................. $0.00
GROSS EDUCATION CREDIT PER COMPUTER:........................................... $0.00
RETIREMENT SAVINGS CNTRB CREDIT:............................................... $0.00
RETIREMENT SAVINGS CNTRB CREDIT PER COMPUTER:.................................. $0.00
* According to the 2012-2013 AVG, “…treat tax-free contributions to an HSA as untaxed income” (p. AVG-19).
28
Tracking Number:
XXXXXXXXXXXX
PRIM RET SAV CNTRB: F8880 LN6A:................................................ $0.00
SEC RET SAV CNTRB: F8880 LN6B:................................................. $0.00
TOTAL RETIREMENT SAVINGS CONTRIBUTION: F8880 CMPTR:............................ $0.00
RESIDENTIAL ENERGY CREDIT:..................................................... $0.00
RESIDENTIAL ENERGY CREDIT PER COMPUTER:........................................ $0.00
CHILD TAX CREDIT:............................................................ $673.00
CHILD TAX CREDIT PER COMPUTER:............................................... $673.00
ADOPTION CREDIT: F8839:........................................................ $0.00
ADOPTION CREDIT PER COMPUTER:.................................................. $0.00
FORM 8839 REFUND ADOPTION CREDIT AMOUNT:....................................... $0.00
DC 1ST TIME HOMEBUYERS CREDIT:................................................. $0.00
DC 1ST TIME HOMEBUYERS CREDIT PER COMPUTER:.................................... $0.00
FORM 8396 MORTGAGE CERTIFICATE CREDIT:......................................... $0.00
FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER:............................ $0.00
F3800, F8801 AND OTHER CREDIT AMOUNT:.......................................... $0.00
FORM 3800 GENERAL BUSINESS CREDITS:............................................ $0.00
FORM 3800 GENERAL BUSINESS CREDITS PER COMPUTER:............................... $0.00
FORM 1040C CREDIT:............................................................. $0.00
PRIOR YR MIN TAX CREDIT: F8801:................................................ $0.00
PRIOR YR MIN TAX CREDIT: F8801 PER COMPUTER:................................... $0.00
F8834 ELECTRIC VEHICLE CREDIT AMOUNT:.......................................... $0.00
F8936 ELECTRIC MOTOR VEHICLE CREDIT AMOUNT:.................................... $0.00
F8910 ALTERNATIVE MOTOR VEHICLE CREDIT AMOUNT:................................. $0.00
OTHER CREDITS:................................................................. $0.00
TOTAL CREDITS:................................................................. $0.00
TOTAL CREDITS PER COMPUTER:.................................................... $0.00
55 INCOME TAX AFTER CREDITS PER COMPUTER:......................................... $0.00
Other Taxes
SE TAX:........................................................................
SE TAX PER COMPUTER:...........................................................
SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS:...........................
SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS PER COMPUTER:..............
TAX ON QUALIFIED PLANS F5329 (PR):.............................................
TAX ON QUALIFIED PLANS F5329 PER COMPUTER:.....................................
IRAF TAX PER COMPUTER:.........................................................
TP TAX FIGURES (REDUCED BY IRAF) PER COMPUTER:.................................
IMF TOTAL TAX (REDUCED BY IRAF) PER COMPUTER:..................................
ADVANCED EARNED INCOME CREDIT:.................................................
RECOVERY REBATE CREDIT AMOUNT:.................................................
UNPAID FICA ON REPORTED TIPS:..................................................
OTHER TAXES:...................................................................
RECAPTURE TAX F8611:...........................................................
HOUSEHOLD EMPLOYMENT TAXES:....................................................
HOUSEHOLD EMPLOYMENT TAXES PER COMPUTER:.......................................
RECAPTURE TAXES:...............................................................
TOTAL ASSESSMENT PER COMPUTER:.................................................
TOTAL TAX LIABILITY TP FIGURES:................................................
TOTAL TAX LIABILITY TP FIGURES PER COMPUTER:...................................
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Payments
FEDERAL INCOME TAX WITHHELD:............................................... $2,756.00
COBRA PREMIUM SUBSIDY:......................................................... $0.00
ESTIMATED TAX PAYMENTS:........................................................ $0.00
MAKING WORK PAY AND GOV’T RET CREDIT:.......................................... $0.00
MAKING WORK PAY AND GOV’T RET CREDIT PER COMPUTER:............................. $0.00
MAKING WORK PAY AND GOV’T RET CREDIT VERIFIED:................................. $0.00
REFUNDABLE EDUCATION CREDIT:................................................... $0.00
REFUNDABLE EDUCATION CREDIT PER COMPUTER:...................................... $0.00
REFUNDABLE EDUCATION CREDIT VERIFIED:.......................................... $0.00
EARNED INCOME CREDIT:...................................................... $1,871.00
EARNED INCOME CREDIT PER COMPUTER:......................................... $1,871.00
EARNED INCOME CREDIT NONTAXABLE COMBAT PAY:.................................... $0.00
SCHEDULE M NONTAXABLE COMBAT PAY:.............................................. $0.00
FORM 8812 NONTAXABLE COMBAT PAY:............................................... $0.00
EXCESS SOCIAL SECURITY & RRTA TAX WITHHELD:.................................... $0.00
TOT SS/MEDICARE WITHHELD: F8812:............................................... $0.00
FORM 8812 ADDITIONAL CHILD TAX CREDIT:....................................... $327.00
FORM 8812 ADDITIONAL CHILD TAX CREDIT PER COMPUTER:.......................... $327.00
FORM 8812 ADDITIONAL CHILD TAX CREDIT VERIFIED:................................ $0.00
29
Tracking Number:
XXXXXXXXXXXX
AMOUNT PAID WITH FORM 4868:.................................................... $0.00
FORM 2439 REGULATED INVESTMENT COMPANY CREDIT:................................. $0.00
FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS:..................................... $0.00
FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS PER COMPUTER:........................ $0.00
HEALTH COVERAGE TX CR: F8885:.................................................. $0.00
FORM 8801 REFUNDABLE CREDIT FOR PRIOR YEAR MIN. TAX:........................... $0.00
67 FIRST TIME HOME BUYER CREDIT PER COMPUTER:..................................... $0.00
FIRST TIME HOME BUYER CREDIT:.................................................. $0.00
FIRST TIME HOME BUYER CREDIT VERIFIED:......................................... $0.00
PRIMARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT:............................. $0.00
SECONDARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT:........................... $0.00
FIRST TIME HOMEBUYER CREDIT REPAYMENT AMOUNT:.................................. $0.00
FORM 2555 COMBINED EARNED INCOME AMOUNT PER COMPUTER: ......................... $0.00
FORM 5405 TOTAL HOMEBUYERS CREDIT REPAYMENT PER COMPUTER:...................... $0.00
SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER:.................................. $0.00
SMALL EMPLOYER HEALTH INSURANCE PER COMPUTER (2):.............................. $0.00
FORM 2439, 8801, and OTHER CREDIT TOTAL AMT:................................... $0.00
TOTAL PAYMENTS:............................................................ $4,954.00
TOTAL PAYMENTS PER COMPUTER:............................................... $4,954.00
Refund or Amount Owed
REFUND AMOUNT:............................................................ $-4,954.00
APPLIED TO NEXT YEAR’S ESTIMATED TAX:.......................................... $0.00
ESTIMATED TAX PENALTY:......................................................... $0.00
TAX ON INCOME LESS STATE REFUND PER COMPUTER:.................................. $0.00
BAL DUE/OVER PYMT USING TP FIG PER COMPUTER:.............................. $-4,954.00
BAL DUE/OVER PYMT USING COMPUTER FIGURES:................................. $-4,954.00
FORM 8888 TOTAL REFUND PER COMPUTER:........................................... $0.00
Third Party Designee
THIRD PARTY DESIGNEE ID NUMBER:................................................. XXXX
AUTHORIZATION INDICATOR:........................................................... X
THIRD PARTY DESIGNEE NAME:............................................. TAX GROUP INC
Schedule EIC--Earned Income Credit
QUALIFIED EIC DEPENDENTS:.......................................................... 1
CHILD 1
CHILD’S NAME CNTRL:.......................................................... DAVI
SSN:.................................................................. DDD-DD-DDDD
YEAR OF BIRTH:............................................................... 2007
STUDENT/DISABLED:..............................................................
0
NUMBER OF MONTHS CHILD LIVED WITH YOU:......................................... 12
CHILD’S RELATIONSHIP TO YOU:............................................. stepchild
CHILD 2
CHILD’S NAME CNTRL:...............................................................
SSN:..............................................................................
YEAR OF BIRTH:................................................................0000
STUDENT/DISABLED:................................................................0
NUMBER OF MONTHS CHILD LIVED WITH YOU:............................................
CHILD’S RELATIONSHIP TO YOU:.......................................son or daughter
CHILD 3
CHILD’S NAME CNTRL:...............................................................
SSN:..............................................................................
YEAR OF BIRTH:................................................................0000
STUDENT/DISABLED:................................................................0
NUMBER OF MONTHS CHILD LIVED WITH YOU:............................................
CHILD’S RELATIONSHIP TO YOU:.......................................son or daughter
30
Tracking Number:
XXXXXXXXXXXX
Form 8863 – Education Credits (Hope and Lifetime Learning Credits)
PART III – ALLOWABLE EDUCATION CREDITS
GROSS EDUCATION CR PER COMPUTER:............................................... $0.00
TOTAL EDUCATION CREDIT AMOUNT:................................................. $0.00
TOTAL EDUCATION CREDIT AMOUNT PER COMPUTER:.................................... $0.00
Form 8867 Paid Preparer's Earned Income Credit Checklist
TAXPAYER QUALIFYING CHILD OF ANOTHER:................................ No box checked
CHILD 1 RELATIONSHIP TO TAXPAYER:................................... Yes box checked
CHILD 2 RELATIONSHIP TO TAXPAYER:................................ Neither box checked
CHILD 3 RELATIONSHIP TO TAXPAYER:................................ Neither box checked
CHILD 1 LIVE WITH TAXPAYER:......................................... Yes box checked
CHILD 2 LIVE WITH TAXPAYER:...................................... Neither box checked
CHILD 3 LIVE WITH TAXPAYER:...................................... Neither box checked
CHILD 1 CLAIMED BY OTHER PERSON:..................................... No box checked
CHILD 2 CLAIMED BY OTHER PERSON:................................. Neither box checked
CHILD 3 CLAIMED BY OTHER PERSON:................................. Neither box checked
CHILD 1 RELATIONSHIP TO OTHERS:..................................... son or daughter
CHILD 2 RELATIONSHIP TO OTHERS:..................................... son or daughter
CHILD 3 RELATIONSHIP TO OTHERS:..................................... son or daughter
CHILD 1 TIEBREAKER RULES:.................................. None of the boxes checked
CHILD 2 TIEBREAKER RULES:.................................. None of the boxes checked
CHILD 3 TIEBREAKER RULES:.................................. None of the boxes checked
FORM 8867 INFORMATION PROVIDED BY TAXPAYER:......................... Yes box checked
KNOWLEDGE REQUIREMENTS COMPLIANCE:.................................. Yes box checked
This Product Contains Sensitive Taxpayer Data
31
Recently-Filed Tax Returns
Challenges with Using the IRS
Data Retrieval Tool
FOTW applicants may find their IRS data is not available yet
based on when and how they filed their income tax
returns. In general, tax filers can expect IRS data to be
available within:
Dear Colleague Letter GEN-11-03.
Some FOTW applicants may choose not to access and
transfer their federal income information. Other applicants
will find they either cannot or should not use the IRS data
retrieval tool. When the IRS data is not retrieved to
populate the FAFSA, the school must obtain alternate
documentation from applicants selected for verification,
such as tax transcripts.
Two weeks for tax returns filed electronically.
u
Eight weeks for tax returns mailed to the IRS.
Applicants who recently filed their federal income tax
returns cannot retrieve their IRS data. The ISIR will reflect
that IRS data was not used and, unless the data is retrieved
at a later date, alternate documentation will be required if
the applicant is selected for verification.
For the 2011-2012 award year, there are no adverse
consequences for FOTW applicants who proceed without
retrieving their IRS data. In Dear Colleague Letter GEN-1103, ED outlined how the rules will change for the 20122013 award year:
Tax Returns Not Yet Filed
u
All FOTW applicants will be directed to use the IRS data
retrieval tool if they indicate they already have filed a
federal income tax return and are otherwise eligible to
use retrieved data.
u
Applicants who indicate they have not yet filed a federal
income tax return will be sent email reminders by ED to
update their FAFSA data using the IRS data retrieval tool
once they have filed their tax returns.
u
Applicants who retrieve IRS data but subsequently
change it, and are selected for verification, will be
expected to provide their schools with information
obtained directly from the IRS, along with an explanation
of why information they provided on the FAFSA is more
accurate than the information that would have been
obtained directly from the IRS.
u
u
Some applicants may need to complete the FAFSA before
filing their federal income tax returns. They should indicate
on the FAFSA that they “will file” but have not yet
completed their tax returns. In GEN-11-03, ED explained
that these applicants will be notified at the time they are
completing FOTW of the need to correct their applications
once their tax returns have been filed. The Department will
send reminders to these applicants, encouraging them to
use the IRS data retrieval tool to correct their information.
Until they do, their ISIRs will reflect that the IRS data was
not retrieved, which indicates to their schools that
alternate documentation must be requested if the
applicant is selected for verification.
Amended Tax Returns
Some tax filers may change or correct the federal income
tax return originally filed with the IRS before or after
completing the FAFSA. These individuals will not be able to
access the amended information through the IRS data
retrieval process.
Applicants who already have filed a federal income tax
return but choose not to use the IRS data retrieval tool
will be subject to being selected for verification and — if
they are selected — required to support their responses
on FOTW with information obtained directly from the IRS.
Alternate documentation is required to complete
verification:
For some applicants, the IRS data retrieval tool will not
provide the information needed to complete their
applications.
u
Original tax data on a tax return transcript and amended
tax data on a tax account transcript, OR
u
Original and amended tax data on a record of account.
NOTES
32
Mismatched Marital Status
Tax filers could qualify to file a joint income tax return based on marital status as of December 31 of the tax year and
subsequently indicate a different marital status by the time they are applying for federal financial aid. In this case it is not
appropriate to retrieve IRS data. Instead, these tax filers should skip the IRS data retrieval process, making sure to
correctly reflect their income, taxes paid and untaxed income.
Likewise, it would not be appropriate for tax filers to use the DRT if they filed a 2011 return as 'single' and indicate a
marital status on their FAFSA as 'married/remarried'.
In both cases the use of the DRT would result in inaccurate information and a CPS-selected applicant would be required
to provide additional documentation for verification.
Rollovers
While the IRS data retrieval process accesses several types of income, the system cannot identify income the tax filer
reports as a rollover from one retirement fund to another during the tax year. Unless the rollover amount is subtracted
from the AGI by the tax filer, the income will be incorrectly overstated. During the IRS data retrieval process, the tax filer is
cautioned that he should subtract any rollover amounts for untaxed IRA distributions or untaxed pensions once the
information is transferred. Once corrected, however, the ISIR will reflect that the IRS data was altered after it was retrieved.
Schools must obtain alternate tax documents as well as documentation of the rollover to complete verification.
NOTES
33
Conflicting Information
Trainer’s Toolkit
Information held by any of the school’s offices that may
affect a student’s eligibility for Title IV aid and that conflicts
with other information obtained about the student. A
school must have an internal system to identify conflicting
information that would affect a student’s eligibility,
regardless of the source or whether the student is selected
for verification. The school must resolve all conflicting
information and discrepancies before disbursing Title IV
funds. If the school discovers discrepancies after disbursing
funds, it must reconcile the conflicting information and
take appropriate action under the specific program
requirements.
The Trainer’s Toolkit is a listing of terms, Web sites and
reference material directly related to Verification.
Terms, Acronyms and
Abbreviations
Adjusted Gross Income
AGI
For federal income tax purposes, gross income less
adjustments (for example, IRA deductible contributions
and self-employment health insurance deductions) but
before standard or itemized deductions and personal
exemptions.
Disbursement
The transfer of loan proceeds to a student or a student’s
school account. For a consolidation loan, disbursement is
the transfer of loan proceeds to the current holder(s) of the
loan(s) being consolidated.
Award Year
The period between July 1 of one calendar year and June
30 of the following calendar year.
Expected Family Contribution
Central Processing System
EFC
The Expected Family Contribution is a measure of how
much a student and the student's spouse or family is
expected to contribute toward the student's Cost of
Attendance. The federal need-analysis methodology must
be used to calculate the EFC. The EFC is not the amount of
money that a student or student's family must provide.
Rather, the EFC is an index used to determine how much
financial aid a student will receive at a particular school.
CPS
An ED contractor that processes Free Application for
Federal Student Aid data. The CPS receives FAFSA
information, performs data matches with certain federal
databases such as the National Student Loan Data System,
Internal Revenue Service and the U.S. Department of
Homeland Security, calculates the student's Expected
Family Contribution, selects certain applicants for
verification, determines if there is a database match error
(C Code) and sends the Student Aid Report to the student
and the Institutional Student Information Report to the
school.
Federal Register
FR
A federal government publication, published each
weekday (except federal holidays), that lists regulations,
regulatory amendments, notices, notices of updated
materials or forms in the development process, and
proposed regulatory changes for all federal executive
agencies.
Code of Federal Regulations
CFR
The collection of federal regulations written and published
by the U.S. government. The U.S. Department of
Education's regulations are codified in Title 34.
Free Application for
Federal Student Aid
FAFSA
www.FAFSA.gov.
The form that students and parents of dependent students
must complete annually to apply for Title IV assistance,
including Pell Grants, Stafford loans, and PLUS loans. A
student and parents of a dependent student must include
financial information about their household so that the
Expected Family Contribution can be calculated.
35
Independent Student
Overpayment
A student who meets one or more of the following criteria:
An individual who is at least 24 years old by Dec. 31 of the
award year; is an orphan or ward of the court; is serving on
active duty in the U.S. Armed Forces for purposes other
than training; is a veteran of the U.S. Armed Forces; is a
graduate or professional student; is a married person; is an
individual with legal dependents other than a spouse; is an
individual who is or was, immediately prior to attaining the
age of majority, an emancipated minor or in legal
guardianship as determined by a court in the student's
state of legal residence; is a student for whom the school’s
financial aid administrator determines and documents the
student's independent status based on the administrator's
professional judgment of the student's unusual
circumstances.
Any amount of financial aid paid to a student in excess of
the amount the student was eligible to receive.
Policies and Procedures Manual
PPM
An in-house manual or set of documentation that helps an
institution effectively and consistently manage financial
aid. Although ED does not require such a manual, it
strongly recommends that a school compile one, especially
because federal regulations require schools to have,
maintain and disclose certain policies in writing.
Quality Assurance Program
QA
Institutional Student
Information Record
Allows institutions the flexibility to design an institutional
verification program that more directly focuses on their
own population segments. QA also has helped institutions
target areas of administration that affect award accuracy
and customer service or that may leave the institution
vulnerable to potential liabilities.
ISIR
An electronic record provided to the school by the Central
Processing System. The ISIR includes information provided
by a student and parents on the Free Application for
Federal Student Aid, the student’s Expected Family
Contribution and the results of federal database matches.
Student Aid Report
SAR
Internal Revenue Service
A record provided to the student by the Central Processing
System. The SAR includes information provided by the
student on the Free Application for Federal Student Aid.
The SAR also contains the student’s Expected Family
Contribution and the results of federal database matches
(including citizenship and Social Security number
matches).
IRS
www.irs.gov.
The federal agency responsible for administering and
enforcing the U.S. Treasury Department's revenue laws,
through the assessment and collection of taxes,
determination of pension plan qualification and related
activities.
Title IV Student Financial Aid
Federal student financial aid programs for students
attending postsecondary institutions. These programs are
authorized under Title IV of the Higher Education Act of
1965, as amended, and administered by the Department of
Education. They include Federal Pell Grants, Teacher
Education Assistance for College and Higher Education
Grants, Federal Supplemental Educational Opportunity
Grants, Federal Work-Study, Federal Perkins Loans, Federal
Stafford loans and Federal PLUS loans.
IRS Form 1040 (1040A and 1040EZ)
The basic form that is used by taxpayers to file their income
tax returns.
IRS Form W-2
A federal wage and tax statement showing:
u
Total earnings.
u
Federal state and municipal taxes withheld.
u
FICA taxes.
u
Various other deductions including contributions to
retirement accounts, unemployment insurance and
health insurance.
Tolerance (Verification)
ED allows schools the option to exercise tolerance for any
verification changes that do not significantly affect student
aid eligibility. The combined limit on dollar-related items
currently is $400; all non-dollar-related items must be
changed. If non-dollar-related items must be altered,
tolerance may not be used. Effective July 1, 2012, the
tolerance will change to $25 or more per dollar item.
36
U.S. Department of Education
ED
The U.S. Department of Education is the government
agency that administers federal student financial aid
programs, including the Federal Pell Grant, the Teacher
Education Assistance for College and Higher Education
Grant, the Federal Work-Study Program, the Federal Perkins
Loan Program, the Federal Family Education Loan Program
and the Federal Direct Loan Program.
Verification
A school’s procedure for confirming the accuracy of
information reported by the student on the Free
Application for Federal Student Aid. Verification may
include requesting a copy of tax documents from the
student and, if applicable, the student's parents.
37
References, Resources and Websites
U.S. Department of Education
Dear Colleague Letter GEN-11-13
Subject: 2012-2013 Award Year: FAFSA Information to be Verified, and Acceptable Documentation.
July 13, 2011.
www.ifap.ed.gov/dpcletters/GEN1113.html.
Dear Colleague Letter GEN-11-03
Subject: Enhancements to the FAFSA-IRS Data Retrieval Process.
Feb. 23, 2011.
www.ifap.ed.gov.
Federal Register Notice
Free Application for Federal Student Aid (FAFSA); Information To Be Verified for the 2012–2013 Award Year.
Vol. 76, No. 134.
July 13, 2011.
www.gpo.gov/fdsys/pkg/FR-2011-07-13/pdf/2011-17655.pdf.
Federal Register
Program Integrity Issues; Final Rule.
Oct. 29, 2010.
www.gpo.gov/fdsys/pkg/FR-2010-10-29/pdf/2010-26531.pdf.
2012-2013 Federal Student Aid Handbook
Application and Verification Guide.
www.ifap.ed.gov.
2012-2013 ISIR Guide
http://ifap.ed.gov/isirguide/1213ISIRGuide.html.
Completing the FAFSA 2012-2013
http://studentaid.ed.gov/students/attachments/siteresources/2012-13CTF.pdf.
2012-2013 Free Application for Federal Student Aid
www.fafsa.ed.gov/fotw1213/pdf/PdfFafsa12-13.pdf.
Electronic Announcement
Subject: Revised 2012-2013 FAFSA Verification - IRS Tax Return Transcript Matrix.
March 16, 2012.
http://ifap.ed.gov/eannouncements/031612FAFSA1213VerificationIRSTaxReturnMatrix.html.
Electronic Announcement
Subject: 2012-13 FAFSA Verification-IRS Tax Return Transcript Matrix.
Feb. 24, 2012.
http://ifap.ed.gov/eannouncements/022412Verification1213IRSTaxReturnMatrix.html.
Electronic Announcement
Subject: Implementation of the 2012-2013 IRS Data Retrieval Tool.
Feb. 2, 2012.
www.ifap.ed.gov/eannouncements/020212Implementationof1213IRSDataRetrievalTool.html.
39
Other Federal Departments
Internal Revenue Service
Publication 17: Your Federal Income Tax (For Individuals).
Publication 54: Tax Guide for U.S. Citizens and Resident Aliens Abroad.
Publication 519: U.S. Tax Guide for Aliens.
Publication 559: Survivors, Executors, and Administrators.
Publication 570: Tax Guide for Individuals with Income from U.S. Possessions.
Publication 915: Social Security and Equivalent Railroad Retirement Benefits.
Publication 970: Tax Benefits for Education.
www.irs.gov.
USA Funds
USA Funds Ask PolicySM
USA Funds Ask PolicySM is a resource for schools and lenders who have questions about specific policies or other issues
related to the full range of Title IV federal student aid.
www.usafunds.org/AskPolicy.
Verification Requirements for 2012-2013
Policy Fact Sheets.
www.usafunds.org/schools/Pages/Policy.aspx.
40
Appendices
Appendix A
Criteria for 2012-2013 Simplified Needs Formulas and Automatic-Zero EFC
Calculation
Appendix B
2011 Federal Tax Return: Eligible to file a 1040A/EZ?
Appendix C
Verification Checklist
Appendix D
IRS Transcript Request Forms
Appendix E
2012-2013 FAFSA
Appendix F
Electronic Announcement, Feb. 24, 2012
Appendix G
2012-2013 Application and Verification Guide, p. AVG-19
41
Appendix A
Criteria for 2012-2013 Simplified Needs Formulas and Automatic-Zero EFC
Calculation
The following criteria is used to determine if students qualify to have their EFCs calculated using a simplified formula.
Simplified
(assets not considered)
Parents had a 2011 AGI of $49,999 or less (for
tax filers), or if non-filers, income earned from
work in 2011 is $49,999 or less; and
u Either
– Parents filed or are eligible to file a 2011 IRS
Form 1040A or 1040EZ (or not required to
file any income tax return) or
– Anyone in the parents’ household size (as
defined on the FAFSA) received meanstested federal benefits during 2010 or
2011, or
– Parent is a dislocated worker.
u
Dependent student
Student (and spouse, if any) had a 2011 AGI
of $49,999 or less (for tax filers), or if
nonfilers, income earned from work in 2011
is $49,999 or less; and
u Either
– Student (and spouse, if any) filed or is
Independent student
eligible to file a 2011 IRS Form 1040A or
without dependents
1040EZ (or not required to file any income
(other than a spouse)
tax return) or
– Anyone in the student’s household size (as
defined on the FAFSA) received meanstested federal benefits during 2010 or
2011, or
– Student (or spouse, if any) is a dislocated
worker.
Automatic Zero EFC
Parents had a 2011 AGI of $23,000 or less (for
tax filers), or if non-filers, income earned from
work in 2011 is $23,000 or less; and
u Either
– Parents filed or are eligible to file a 2011 IRS
Form 1040A or 1040EZ (or not required to
file any income tax return) or
– Anyone in parents’ household size (as
defined on the FAFSA) received meanstested federal benefits during 2010 or
2011, or
– Parent is a dislocated worker.
u
u
Student (and spouse, if any) had a 2011 AGI
of $49,999 or less (for tax filers), or if
nonfilers, income earned from work in 2011
is $49,999 or less; and
u Either
– Student (and spouse, if any) filed or is
Independent student
eligible to file a 2011 IRS Form1040A or
with dependents
1040EZ (or not required to file any income
(other than a spouse)
tax return) or
– Anyone in the student’s household size (as
defined on the FAFSA) received meanstested federal benefits during 2010 or
2011, or
– Student (or spouse, if any) is a dislocated
worker.
u
42
Not applicable.
Student (and spouse, if any) had a 2011 AGI
of $23,000 or less (for tax filers), or if
nonfilers, income earned from work in 2011
is $23,000 or less; and
u Either
– Student (and spouse, if any) filed or is
eligible to file a 2011 IRS Form 1040A or
1040EZ (or not required to file any income
tax return) or
– Anyone in the student’s household size (as
defined on the FAFSA) received meanstested federal benefits during 2010 or
2011, or
– Student (or spouse, if any) is a dislocated
worker.
u
Appendix B
2011 Federal Tax Return: Eligible to file a 1040A/EZ?
“If you have filed or will file a 1040, were you eligible to file a 1040A or 1040EZ?” (2012-2013 FAFSA questions 34 and 81.)
YES, IF taxable income from line 43 is less than $100,000 –AND–
IF amounts (other than zero) do not appear on the following lines:
1040 Section
Line #
Description
10
11
12
13
14
17
18
21
Taxable refunds, credits or offsets of state/local income taxes.
Alimony received.
Business income or loss.
Capital gain or loss (ignore if Sch. D was not required).
Other gains or losses.
Rental real estate, royalties, partnerships, etc.
Farm income or loss.
Other income.
24
25
26
27
28
29
30
31a
35
Certain business expenses of reservists, performing artists, and fee-basis
government officials.
Health savings account deduction.
Moving expenses.
Deductible part of self-employment tax.
Self-employed SEP, SIMPLE and qualified plans.
Self-employed health insurance deduction.
Penalty on early withdrawal of savings.
Alimony paid.
Domestic production activities deduction.
Tax and Credits
40
43
44
47
52
53
Cannot have itemized deductions.
Taxable income must be less than $100,000.
Forms 8814, 4972 or 962 election cannot be checked.
Foreign tax credit.
Residential energy credit.
Credits from Form 3800, 8801 or other.
Other Taxes
56
57
58
59a
59b
60
Self-employment tax.
Unreported SS and Medicare tax from Form 4137 or 8919.
Additional tax on IRAs, other qualified retirement plans, etc.
Household employment taxes from Schedule H.
First-time homebuyer credit repayment.
Other taxes.
Payments
67
68
69
70
71
First-time home buyer credit.
Amount paid with request for extension to file.
Excess social security and tier 1 RRTA tax withheld.
Credit for federal tax on fuels.
Credits from Form 2439, 8839, 8801 or 8885.
Income
Adjusted Gross Income
If all of the above conditions apply, the tax filer was eligible to file a 1040A or 1040EZ but filed a 1040 for other reasons.
Therefore, the tax filer should answer YES to question 34 (student) or 81 (parent) on the 2012-2013 FAFSA.
Persons filing a foreign tax return are considered to have filed a long-form 1040.
43
Disclaimer Concerning Summary of Federal Tax Information
The following is a summary of United States federal income tax information and tax filing requirements that may
generally be applicable to those individuals enrolled in post secondary/higher education programs.
This summary is for general information only and does not constitute tax advice. The summary represents general
information only and is based on the Internal Revenue code, its legislative history, existing and proposed United States
Treasury regulations, Internal Revenue Service administrative rulings, publications and notices, and court decisions in
effect as of January 1, 2011, and all of which are subject to change or differing interpretations (possibly with retroactive
effect) and any change could affect the continuing validity of the information contained in this summary.
This summary does not reflect every possible tax outcome, consequence and/or requirements that may be applicable to
individuals. Also, this summary does not discuss the tax consequences or requirements if the individual is not a United
States citizen or a resident alien. Any state tax consequences and requirements will vary from state to state, and any tax
consequences and requirements of individuals who reside outside the United States will vary from jurisdiction to
jurisdiction.
Individuals are advised to consult their own tax advisors to determine the tax consequences and requirements particular
to their own individual situation, including any applicable state, local or foreign income and other tax consequences and
requirements that may apply.
44
45
Copy of a W-2 Form received in the base year from each source of employment.
Signed statement certifying the applicant has not filed and is not required to file for the tax year, and the sources and amounts
of income earned from work reported on the FAFSA not listed on a W-2 Form.
‹
‹
2/12 MKCM-664 © 2012 United Student Aid Funds, Inc. All rights reserved.
# Must be attending a school that is eligible to participate in Title IV programs.
Income Earned From Work
‹
Completed verification worksheet or statement signed by the dependent student’s parent or the independent student certifying
that they, or another member of the household, received Food Stamps in 2010 or 2011.
Alternately, the school may choose to require documentation from the applicable Food Stamp issuing agency, rather than a
signed statement.
Food Stamps (SNAP)
‹
Completed verification worksheet or statement signed by the individual who paid support, listing the amount paid, the child support recipient, and the name of the child (children) for whom support was paid.
If the school believes information is inaccurate, it must obtain documentation such as a copy of a separation agreement/divorce
decree showing the amount to be paid, a statement from the child support recipient showing the amount paid, or copies of
canceled checks or money order receipts.
‹
‹
Completed verification worksheet or signed statement from an applicant (or applicant and parent, if dependent) listing the name
and age of each household member attending an eligible school# at least half time for the award year, and the name(s) of the
applicable school(s).
If the school believes information from the Free Application for Federal Student Aid or the signed statement is inaccurate, it
must obtain a statement from each listed school unless the household member is not yet registered or will attend the
applicant’s school.
Not required when the number in college is 1.
Number in College
‹
‹
‹
‹
Completed verification worksheet or signed statement from an applicant (or applicant and parent, if dependent) listing the name
and age of each household member and the relationship to the applicant.
Not required when:
Dependent student lists 2 and parent is single, divorced, separated or widowed.
Dependent student lists 3 and parents are married.
Independent student lists 1 and student is single, divorced, separated or widowed.
Independent student lists 2 and student is married.
Acceptable Documentation
Child Support Paid
Non-Tax Filer
Tax Filer
Household Size
Data Elements
The Program Integrity Final Rule published by the U. S. Department of Education on Oct. 29, 2010, made numerous changes to verification regulations. One of the most prominent of those
changes replaced the standard required verification data items with a list of new data items that ED plans to revise annually. USA Funds® provides a checklist of documentation schools must
verify for the 2012-2013 award year for three categories of applicants: Tax filers, non-tax filers and tax filers with special circumstances.
Verification Requirements for 2012-2013
Appendix C
Verification Checklist
Data Elements
AGI*
U.S. Tax Paid*
Untaxed IRA Distributions*
Untaxed Pensions*
Education Credits*
IRA Deductions*
Tax-Exempt Interest*
Data Elements
AGI
U.S. Tax Paid
Untaxed Pensions
Untaxed IRA Distributions
IRA Deductions
Education Credits
Tax-Exempt Interest
Tax Filer
‹
‹
Non-Tax Filer
‹
Acceptable Documentation
Each of these data elements may be populated on the FAFSA via the IRS Data Retrieval process. If the applicant (and/or the
parent, if the applicant is a dependent student):
Used the IRS Data Retrieval process and the information is unchanged (02 IRS Request Flag), the school need not require
additional tax information.
Did not use the IRS Data Retrieval process or did use the process but subsequently changed any of the data, the school
must obtain a tax transcript.
‹
*Acceptable Documentation for Tax Filers With Special Circumstances
1. Individual filed a joint return but now is separated, divorced, widowed or married to another individual:
Tax transcript listing the tax filer’s information for the applicable tax year.
If the student (and/or the dependent student’s parent) no longer is married to the individual on the joint return, a copy of the W-2 Form
for each employment source for the student or dependent student’s parent(s) whose income is used to calculate the applicant’s Expected
Family Contribution.
‹
2. Individual was granted a filing extension by the IRS:
Copy of Form 4868 or a copy of the IRS approval of the extension beyond the six-month period.
Copy of a W-2 Form for each source of employment received in the base year by the individual granted the extension or a signed statement
of Adjusted Gross Income and tax paid if the individual is self-employed.
‹
‹
3. Individual requested a tax transcript and the IRS, U.S. territory or commonwealth or foreign country cannot provide the requested data:
Copy of a W-2 Form for each source of employment received by the individual for the base year.
Signed statement of AGI and tax paid if the individual is self-employed or filed a tax return with a foreign government, or U. S. territory
or commonwealth.
‹
46
Appendix D
IRS Transcript Request Forms
Form
4506T-EZ
Short Form Request for Individual Tax Return Transcript
OMB No. 1545-2154
(Rev. January 2012)
Department of the Treasury
Internal Revenue Service
a Request
may not be processed if the form is incomplete or illegible.
Tip. Use Form 4506T-EZ to order a 1040 series tax return transcript free of charge, or you can quickly request transcripts by using our automated self-help
service tools. Please visit us at IRS.gov and click on “Order a Transcript” or call 1-800-908-9946.
1a Name shown on tax return. If a joint return, enter the name shown first.
1b First social security number or individual taxpayer
identification number on tax return
2a If a joint return, enter spouse’s name shown on tax return.
2b Second social security number or individual
taxpayer identification number if joint tax return
3 Current name, address (including apt., room, or suite no.), city, state, and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5 If the transcript is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address, and telephone number. The
IRS has no control over what the third party does with the tax information.
Third party name
Telephone number
Address (including apt., room, or suite no.), city, state, and ZIP code
Caution. If the tax transcript is being mailed to a third party, ensure that you have filled in line 6 before signing. Sign and date the form once you have
filled in this line. Completing this step helps to protect your privacy. Once the IRS discloses your IRS transcript to the third party listed on line 5, the
IRS has no control over what the third party does with the information. If you would like to limit the third party's authority to disclose your transcript
information, you can specify this limitation in your written agreement with the third party.
6
Year(s) requested. Enter the year(s) of the return transcript you are requesting (for example, “2008”). Most requests will be processed within
10 business days.
Check this box if you have notified the IRS or the IRS has notified you that one of the years for which you are requesting a transcript
involved identity theft on your federal tax return.
Note. If the IRS is unable to locate a return that matches the taxpayer identity information provided above, or if IRS records indicate that the return has
not been filed, the IRS may notify you or the third party that it was unable to locate a return, or that a return was not filed, whichever is applicable.
Caution. Do not sign this form unless all applicable lines have been completed.
Signature of taxpayer(s). I declare that I am the taxpayer whose name is shown on either line 1a or 2a. If the request applies to a joint return, either
husband or wife must sign. Note. For transcripts being sent to a third party, this form must be received within 120 days of the signature date.
Phone number of taxpayer
on line 1a or 2a
F
Signature (see instructions)
F
Sign
Here
Spouse’s signature
Date
Date
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
Cat. No. 54185S
47
Form 4506T-EZ (Rev. 1-2012)
4506-T
Form
(Rev. January 2012)
Department of the Treasury
Internal Revenue Service
Request for Transcript of Tax Return
OMB No. 1545-1872
a
Request may be rejected if the form is incomplete or illegible.
Tip. Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can quickly request transcripts by using
our automated self-help service tools. Please visit us at IRS.gov and click on "Order a Transcript" or call 1-800-908-9946. If you need a copy of your return, use
Form 4506, Request for Copy of Tax Return. There is a fee to get a copy of your return.
1a Name shown on tax return. If a joint return, enter the name
shown first.
1b First social security number on tax return, individual taxpayer identification
number, or employer identification number (see instructions)
2a If a joint return, enter spouse’s name shown on tax return.
2b Second social security number or individual taxpayer
identification number if joint tax return
3 Current name, address (including apt., room, or suite no.), city, state, and ZIP code (see instructions)
4 Previous address shown on the last return filed if different from line 3 (see instructions)
5 If the transcript or tax information is to be mailed to a third party (such as a mortgage company), enter the third party’s name, address,
and telephone number.
Caution. If the tax transcript is being mailed to a third party, ensure that you have filled in lines 6 through 9 before signing. Sign and date the form once
you have filled in these lines. Completing these steps helps to protect your privacy. Once the IRS discloses your IRS transcript to the third party listed
on line 5, the IRS has no control over what the third party does with the information. If you would like to limit the third party's authority to disclose your
transcript information, you can specify this limitation in your written agreement with the third party.
Transcript requested. Enter the tax form number here (1040, 1065, 1120, etc.) and check the appropriate box below. Enter only one tax form
number per request. a
6
a
Return Transcript, which includes most of the line items of a tax return as filed with the IRS. A tax return transcript does not reflect
changes made to the account after the return is processed. Transcripts are only available for the following returns: Form 1040 series,
Form 1065, Form 1120, Form 1120A, Form 1120H, Form 1120L, and Form 1120S. Return transcripts are available for the current year
and returns processed during the prior 3 processing years. Most requests will be processed within 10 business days . . . . . .
b
Account Transcript, which contains information on the financial status of the account, such as payments made on the account, penalty
assessments, and adjustments made by you or the IRS after the return was filed. Return information is limited to items such as tax liability
and estimated tax payments. Account transcripts are available for most returns. Most requests will be processed within 30 calendar days
.
c
Record of Account, which provides the most detailed information as it is a combination of the Return Transcript and the Account
Transcript. Available for current year and 3 prior tax years. Most requests will be processed within 30 calendar days . . . . . . .
7
8
Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Current year requests are only available
after June 15th. There are no availability restrictions on prior year requests. Most requests will be processed within 10 business days . .
Form W-2, Form 1099 series, Form 1098 series, or Form 5498 series transcript. The IRS can provide a transcript that includes data from
these information returns. State or local information is not included with the Form W-2 information. The IRS may be able to provide this
transcript information for up to 10 years. Information for the current year is generally not available until the year after it is filed with the IRS.
For example, W-2 information for 2010, filed in 2011, will not be available from the IRS until 2012. If you need W-2 information for retirement
purposes, you should contact the Social Security Administration at 1-800-772-1213. Most requests will be processed within 45 days . . .
Caution. If you need a copy of Form W-2 or Form 1099, you should first contact the payer. To get a copy of the Form W-2 or Form 1099 filed
with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.
9
Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. If you are requesting more than four
years or periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you must enter
each quarter or tax period separately.
Check this box if you have notified the IRS or the IRS has notified you that one of the years for which you are requesting a transcript
involved identity theft on your federal tax return . . . . . . . . . . . . . . . . . . . . . . . . . . .
Caution. Do not sign this form unless all applicable lines have been completed.
Signature of taxpayer(s). I declare that I am either the taxpayer whose name is shown on line 1a or 2a, or a person authorized to obtain the tax
information requested. If the request applies to a joint return, either husband or wife must sign. If signed by a corporate officer, partner, guardian, tax
matters partner, executor, receiver, administrator, trustee, or party other than the taxpayer, I certify that I have the authority to execute Form 4506-T on
behalf of the taxpayer. Note. For transcripts being sent to a third party, this form must be received within 120 days of the signature date.
Phone number of taxpayer on line
1a or 2a
F F F
Sign
Here
Signature (see instructions)
Date
Title (if line 1a above is a corporation, partnership, estate, or trust)
Spouse’s signature
Date
For Privacy Act and Paperwork Reduction Act Notice, see page 2.
Cat. No. 37667N
48
Form 4506-T (Rev. 1-2012)
Appendix E
2012-2013 FAFSA
SM
Free Application for Federal Student Aid
®
July 1, 2012 — June 30, 2013
U.S. Department of Education
Federal Student Aid
Use this form to apply free for federal and
state student grants, work-study and loans.
Or apply free online at
www.fafsa.gov
®
For federal aid, submit your application as early as possible, but no earlier than
January 1, 2012. We must receive your application no later than June 30, 2013. Your
college must have your correct, complete information by your last day of enrollment
in the 2012-2013 school year.
For state or college aid, the deadline may be as early as January 2012. See the table to
the right for state deadlines. You may also need to complete additional forms.
Check with your high school guidance counselor or a financial aid administrator at
your college about state and college sources of student aid and deadlines.
If you are filing close to one of these deadlines, we recommend you file online at
www.fafsa.gov. This is the fastest and easiest way to apply for aid.
Using Your Tax Return
If you (or your parents) need to file a 2011 income tax return with the Internal Revenue
Service (IRS), we recommend that you complete it before filling out the FAFSA. If you
have not completed your return yet, you can submit your FAFSA now using estimated
tax information, and then correct that information after you file your return.
Filling Out the FAFSA
SM
If you or your family has unusual circumstances that might affect your financial
situation (such as loss of employment), complete this form to the extent you can, then
submit it as instructed and consult with the financial aid office at the college you plan
to attend.
For help in filling out the FAFSA, go to www.studentaid.ed.gov/completefafsa or
call 1-800-4-FED-AID (1-800-433-3243). TTY users (for the hearing impaired) may call
1-800-730-8913.
Fill the answer fields directly on your screen or print the form and complete it by hand.
Your answers will be read electronically; therefore if you complete the form by hand:
•
• report dollar amounts (such as $12,356.41)
like this:
Correct
1 5
$
Pay attention to the symbols that may be listed after
your state deadline.
AK
AR
CA
CT
DC
DE
FL
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NH
NJ
Incorrect x √
E L M
S T
1 2 3 5 6
,
NY
OH
OK
OR
no cents
PA
Orange is for student information and purple is for parent information.
Mailing Your FAFSA
SM
After you complete this application, make a copy of pages 3 through 8 for your
records. Then mail the original of pages 3 through 8 to:
RI
SC
Federal Student Aid Programs, P.O. Box 4692, Mt. Vernon, IL 62864-4692.
After your application is processed, you will receive a summary of your information in
your Student Aid Report (SAR). If you provide an e-mail address, your SAR will be sent
by e-mail within 3-5 days. If you do not provide an e-mail address, your SAR will be
mailed to you within three weeks. If you would like to check the status of your FAFSA,
go to www.fafsa.gov or call 1-800-4-FED-AID.
Let’s Get Started!
Now go to page 3 of the application form and begin filling it out. Refer to the
notes as instructed.
TN
VT
WV
AK Education Grant and AK Performance Scholarship June 30, 2012 (date received)
Academic Challenge - June 1, 2012 (date received)
Workforce Grant - Contact the financial aid office.
Higher Education Opportunity Grant - June 1, 2012
(date received)
Initial awards - March 2, 2012 + *
Additional community college awards - September 2,
2012 (date postmarked) + *
February 15, 2012 (date received) # *
June 30, 2012 (date received) * For priority
consideration, submit application by May 15, 2012.
April 15, 2012 (date received)
May 15, 2012 (date processed)
July 1, 2012 (date received); earlier priority deadlines
may exist for certain programs.
Opportunity Grant - March 1, 2012 (date received) # *
As soon as possible after January 1, 2012. Awards
made until funds are depleted.
March 10, 2012 (date received)
April 1, 2012 (date received) # *
As soon as possible after January 1, 2012. Awards
made until funds are depleted.
June 30, 2013 (July 1, 2012 recommended)
May 1, 2012 (date received) #
March 1, 2012 (date received)
May 1, 2012 (date received)
March 1, 2012 (date received)
30 days after term starts (date received)
April 2, 2012 (date received)
MTAG and MESG Grants - September 15, 2012 (date
received)
HELP Scholarship - March 31, 2012 (date received)
March 1, 2012 (date received) #
As soon as possible after January 1, 2012. Awards
made until funds are depleted.
April 15, 2012 (date received) # Early priority deadlines
may exist for institutional programs.
NH is not offering a state grant this year.
2011-2012 Tuition Aid Grant recipients - June 1, 2012
(date received)
All other applicants
- October 1, 2012, fall & spring terms (date received)
- March 1, 2013, spring term only (date received)
June 30, 2013 (date received) + *
October 1, 2012 (date received)
March 1, 2012 (date received) #
OSAC Private Scholarships - March 1, 2012 (date received)
Oregon Opportunity Grant - February 1, 2012 (date
received)
All first-time applicants at a community college; a
business/trade/technical school; a hospital school of
nursing; or enrolled in a non-transferable two-year
program - August 1, 2012 (date received)
All other applicants - May 1, 2012 (date received)
March 1, 2012 (date received) #
Tuition Grants - June 30, 2012 (date received)
SC Commission on Higher Education - As soon as
possible after January 1, 2012. Awards made until
funds are depleted.
State Grant - As soon as possible after January 1,
2012. Awards made until funds are depleted.
State Lottery - September 1, 2012 (date received) #
As soon as possible after January 1, 2012. Awards
made until funds are depleted. *
Promise Scholarship - March 1, 2012 (date received) # *
WV Higher Education Grant Program - April 16, 2012
(date received) #
# For priority consideration, submit application by date specified.
+ Applicants encouraged to obtain proof of mailing.
* Additional form may be required.
Federal Student Aid logo, arrow symbol and FAFSA are service marks or registered service marks of Federal Student Aid, U.S. Department of Education.
49
STATE AID DEADLINES
The easiest way to complete or correct your FAFSA with accurate tax information is
by using the IRS Data Retrieval Tool through www.fafsa.gov. In a few simple steps,
you may be able to view your tax return information and transfer it directly into your
FAFSA.
• print clearly in CAPITAL letters and skip a
box between words:
Check with your financial aid administrator for these states
and territories:
AL, AS *, AZ, CO, FM *, GA, GU *, HI *, MH *, MP *, NE, NM,
NV *, PR, PW *, SD *, TX, UT, VA *, VI *, WA, WI and WY *.
Applying by the Deadlines
• use black ink and fill in circles completely:
APPLICATION DEADLINES
Federal Aid Deadline - June 30, 2013
State Aid Deadlines - See below.
Notes for questions 14 and 15 (page 3)
Notes for questions 41 and 42 (page 4)
and 89 and 90 (page 7)
If you are an eligible noncitizen, write in your eight- or nine-digit Alien
Registration Number. Generally, you are an eligible noncitizen if you are
(1) a permanent U.S. resident with a Permanent Resident Card (I-551); (2)
a conditional permanent resident with a Conditional Green Card (I-551C);
(3) the holder of an Arrival-Departure Record (I-94) from the Department
of Homeland Security showing any one of the following designations:
“Refugee,” “Asylum Granted,” “Parolee” (I-94 confirms that you were
paroled for a minimum of one year and status has not expired), T-Visa
holder (T-1, T-2, T-3, etc.) or “Cuban-Haitian Entrant;” or (4) the holder of a
valid certification or eligibility letter from the Department of Health and
Human Services showing a designation of “Victim of human trafficking.”
Net worth means current value minus debt. If net worth is negative, enter 0.
Investments include real estate (do not include the home you live
in), trust funds, UGMA and UTMA accounts, money market funds,
mutual funds, certificates of deposit, stocks, stock options, bonds, other
securities, installment and land sale contracts (including mortgages
held), commodities, etc.
Investments also include qualified educational benefits or education
savings accounts (e.g., Coverdell savings accounts, 529 college savings
plans and the refund value of 529 prepaid tuition plans). For a student
who does not report parental information, the accounts owned by the
student (and/or the student’s spouse) are reported as student investments
in question 41. For a student who must report parental information, the
accounts are reported as parental investments in question 89, including
all accounts owned by the student and all accounts owned by the parents
for any member of the household.
If you are in the U.S. on an F1 or F2 student visa, a J1 or J2 exchange visitor
visa, or a G series visa (pertaining to international organizations), select
“No, I am not a citizen or eligible noncitizen.” You will not be eligible for
federal student aid; however, you should still complete the application
because you may be eligible for state or college aid.
Notes for questions 16 and 17 (page 3)
Investments do not include the home you live in, the value of life
insurance, retirement plans (401[k] plans, pension funds, annuities, noneducation IRAs, Keogh plans, etc.) or cash, savings and checking accounts
already reported in questions 40 and 88.
Report your marital status as of the date you sign your FAFSA. If your
marital status changes after you sign your FAFSA, check with the
financial aid office at the college. According to the Defense of Marriage
Act (1996), “…the word ‘marriage’ means a legal union between one
man and one woman as husband and wife, and the word ‘spouse’ refers
to a person of the opposite sex who is a husband or a wife.” Therefore,
same-sex unions are not considered marriages for federal purposes,
including the FAFSA.
Investments also do not include UGMA and UTMA accounts for which
you are the custodian, but not the owner.
Investment value means the current balance or market value of these
investments as of today. Investment debt means only those debts that
are related to the investments.
Notes for question 22 (page 3)
Business and/or investment farm value includes the market value of
land, buildings, machinery, equipment, inventory, etc. Business and/or
investment farm debt means only those debts for which the business or
investment farm was used as collateral.
The Selective Service System, and the registration requirement for young
men, preserves America’s ability to provide manpower in an emergency
to the U.S. Armed Forces. Almost all men—ages 18 through 25—must
register. For more information about Selective Service, visit www.sss.gov.
Business value does not include the value of a small business if your
family owns and controls more than 50 percent of the business and the
business has 100 or fewer full-time or full-time equivalent employees.
For small business value, your family includes (1) persons directly related
to you, such as a parent, sister or cousin, or (2) persons who are or were
related to you by marriage, such as a spouse, stepparent or sister-in-law.
Notes for questions 33 (page 4)
and 80 (page 6)
If you filed or will file a foreign tax return, a tax return with Puerto Rico,
another U.S. territory (e.g., Guam, American Samoa, the U.S. Virgin Islands,
Swain’s Island or the Northern Marianas Islands) or one of the Freely
Associated States (i.e., the Republic of Palau, the Republic of the Marshall
Islands or the Federated States of Micronesia), use the information from
that return to fill out this form. If you filed a foreign return, convert all
monetary units to U.S. dollars, using the exchange rate that is in effect
today. To view the daily exchange rate, go to www.federalreserve.gov/
releases/h10/current.
Investment farm value does not include the value of a family farm that
you (your spouse and/or your parents) live on and operate.
Notes for questions 48 (page 5)
Answer “Yes” if you are currently serving in the U.S. Armed Forces or are
a National Guard or Reserves enlistee who is on active duty for other than
state or training purposes.
Notes for questions 34 (page 4)
and 81 (page 6)
Answer “No” if you are a National Guard or Reserves enlistee who is on
active duty for state or training purposes.
In general, a person is eligible to file a 1040A or 1040EZ if he or she
makes less than $100,000, does not itemize deductions, does not receive
income from his or her own business or farm and does not receive
alimony. A person is not eligible to file a 1040A or 1040EZ if he or she
makes $100,000 or more, itemizes deductions, receives income from
his or her own business or farm, is self-employed, receives alimony or
is required to file Schedule D for capital gains. If you filed a 1040 only to
claim American Opportunity, Hope or Lifetime Learning credits, and you
would have otherwise been eligible for a 1040A or 1040EZ, answer “Yes”
to this question. If you filed a 1040 and were not required to file a tax
return, answer “Yes” to this question.
Notes for question 49 (page 5)
Answer “Yes” (you are a veteran) if you (1) have engaged in active duty
in the U.S. Armed Forces (Army, Navy, Air Force, Marines or Coast Guard)
or are a National Guard or Reserve enlistee who was called to active duty
for other than state or training purposes, or were a cadet or midshipman
at one of the service academies, and (2) were released under a condition
other than dishonorable. Also answer “Yes” if you are not a veteran now
but will be one by June 30, 2013.
Answer “No” (you are not a veteran) if you (1) have never engaged in
active duty in the U.S. Armed Forces, (2) are currently an ROTC student
or a cadet or midshipman at a service academy, (3) are a National Guard
or Reserve enlistee activated only for state or training purposes, or (4)
were engaged in active duty in the U.S. Armed Forces but released under
dishonorable conditions.
Notes for questions 37 (page 4)
and 85 (page 7) — Notes for those who filed a 1040EZ
On the 1040EZ, if a person didn’t check either box on line 5, enter 01
if he or she is single, or 02 if he or she is married. If a person checked
either the “you” or “spouse” box on line 5, use 1040EZ worksheet line F
to determine the number of exemptions ($3,700 equals one exemption).
Also answer “No” if you are currently serving in the U.S. Armed Forces
and will continue to serve through June 30, 2013.
Page 2
50
Notes continued on page 9.
SM
Free Application for Federal Student Aid
July 1, 2012 — June 30, 2013
U.S. Department of Education
Federal Student Aid
®
Step One (Student): For questions 1-31, leave blank any questions that do not apply to you (the student).
OMB # 1845-0001
Your full name (exactly as it appears on your Social Security card) If your name has a suffix, such as Jr. or III, include a space between your last name and suffix.
1. Last
name
2. First
name
3. Middle
initial
Your mailing address
4. Number and street
(include apt. number)
5. City (and country if
not U.S.)
6. State
8. Your Social Security Number
–
9. Your date
of birth
MONTH
DAY
10. Your permanent telephone number
YEAR
(
1 9
–
7. ZIP code
Your driver’s license number and driver’s license state (if you have one)
11. Driver’s license
number
)
–
12. Driver’s license
state
13. Your e-mail address. If you provide your e-mail address, we will communicate with you electronically. For example, when your FAFSA has been processed, you will be
notified by e-mail. Your e-mail address will also be shared with your state and the colleges listed on your FAFSA to allow them to communicate with you. If you prefer to
be contacted by postal mail or do not have an e-mail address, leave this field blank.
@
14. Are you a U.S.
citizen?
Mark only one.
See Notes page 2.
16. What is your
marital status as
of today?
Yes, I am a U.S. citizen (U.S. national). Skip to question 16. . . . . . .
1
No, but I am an eligible noncitizen. Fill in question 15. . . . . . . . . . .
2
No, I am not a citizen or eligible noncitizen. Skip to question 16.
3
I am single . . . . . . . . . . . . .
1
I am separated . . . . . . . . . . .
3
I am married/remarried
2
I am divorced or widowed
4
15. Alien Registration Number
A
17. Month and year you were
married, remarried, separated,
divorced or widowed.
See Notes page 2.
18. What is your
state of legal
residence?
21. Are you male or
female?
MONTH
YEAR
MONTH
YEAR
See Notes page 2.
STATE
19. Did you become a legal
resident of this state
before January 1, 2007?
Male
1
Female
2
Yes
1
No
2
20. If the answer to question 19 is
“No,” give month and year you
became a legal resident.
22. If female, skip to question 23. Most male students must register with Selective
Service to receive federal aid. If you are male, age 18-25 and not registered, fill in
the circle and we will register you. See Notes page 2.
Register me
1
No
1
Yes
3
23. Have you been convicted for the possession or sale of illegal drugs for an offense that occurred while you were receiving
federal student aid (such as grants, loans or work-study)?
Answer “No” if you have never received federal student aid or if you have never had a drug conviction while receiving federal student aid.
If you have a drug conviction for an offense that occurred while you were receiving federal student aid, answer “Yes,” but complete and
submit this application, and we will mail you a worksheet to help you determine if your conviction affects your eligibility for aid. If you are
unsure how to answer this question, call 1-800-433-3243 for help.
Some states and colleges offer aid based on the level of schooling your parents completed.
24. Highest school your father completed
Middle school/Jr. high
1
High school
2
College or beyond
3
Other/unknown
4
25. Highest school your mother completed
Middle school/Jr. high
1
High school
2
College or beyond
3
Other/unknown
4
26. When you begin college in the 2012-2013 school year, what will be your high school completion status?
High school diploma. Answer question 27. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Homeschooled. Skip to question 28. . . . . . . . . . .
3
General Educational Development (GED) certificate. Skip to question 28. . . . . .
2
None of the above. Skip to question 28. . . . . . . .
4
For Help — www.studentaid.ed.gov/completefafsa
Page 3
51
Step One CONTINUED on page 4
Step One CONTINUED from page 3
27. What is the name of the high school where you received or will receive your high school diploma?
Enter the complete high school name, and the city and state where the high school is located.
28. Will you have your first bachelor’s degree
before July 1, 2012?
STATE
High School Name
Yes
1
No
2
High School City
29. When you begin the 2012-2013 school year, what will be your grade
level?
30. When you begin the 2012-2013 school year, what degree or certificate will
you be working on?
Never attended college and 1st year undergraduate . . . . . . . . . . . . .
0
1st bachelor’s degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Attended college before and 1st year undergraduate . . . . . . . . . . . .
1
2nd bachelor’s degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
2
Associate degree (occupational or technical program) . . . . . . . . . . . . . . . . . . . . .
3
2nd year undergraduate/sophomore . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Associate degree (general education or transfer program). . . . . . . . . . . . . . . . . .
4
3rd year undergraduate/junior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4th year undergraduate/senior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
5th year/other undergraduate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
1st year graduate/professional . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Continuing graduate/professional or beyond . . . . . . . . . . . . . . . . . . . .
7
Certificate or diploma (occupational, technical or education program
of less than two years). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Certificate or diploma (occupational, technical or education program
of two or more years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
Teaching credential (nondegree program) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Graduate or professional degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
Other/undecided . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
31. Are you interested in being considered for work-study?
Step Two (Student):
5
Yes
1
No
2
Don’t know
3
Answer questions 32–57 about yourself (the student). If you are single, separated, divorced or widowed,
answer only about yourself. If you are married or remarried as of today, include information about your
spouse (husband or wife).
32. For 2011, have you (the student) completed your IRS income tax
return or another tax return listed in question 33?
I have already completed my return . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
I will file but have not yet completed my return . . . . . . . . . . . . . . . . . .
2
I’m not going to file. Skip to question 38. . . . . . . . . . . . . . . . . . . . . . . .
33. What income tax return did you file or will you file for 2011?
IRS 1040 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
IRS 1040A or 1040EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
A foreign tax return. See Notes page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
A tax return with Puerto Rico, another U.S. territory, or Freely
Associated State. See Notes page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
34. If you have filed or will file a 1040, were you eligible to file a 1040A or 1040EZ?
See Notes page 2.
Yes
1
No
2
Don’t know
4
3
For questions 35–44, if the answer is zero or the question does not apply to you, enter 0. Report whole dollar amounts with no cents.
35. What was your (and spouse’s) adjusted gross income for 2011? Adjusted gross income is on IRS Form 1040—line 37;
1040A—line 21; or 1040EZ—line 4.
$
36. Enter your (and spouse’s) income tax for 2011. Income tax amount is on IRS Form 1040—line 55; 1040A—line 35; or
1040EZ—line 10.
,
$
,
37. Enter your (and spouse’s) exemptions for 2011. Exemptions are on IRS Form 1040—line 6d or Form 1040A—line 6d.
For Form 1040EZ, see Notes page 2.
Questions 38 and 39 ask about earnings (wages, salaries, tips, etc.) in 2011. Answer the questions whether or not a tax return was filed. This
information may be on the W-2 forms, or on IRS Form 1040—lines 7 + 12 + 18 + Box 14 (Code A) of IRS Schedule K-1 (Form 1065); on 1040A—line 7; or
on 1040EZ—line 1. If any individual earning item is negative, do not include that item in your calculation.
38. How much did you earn from working in 2011?
$
39. How much did your spouse earn from working in 2011?
$
40. As of today, what is your (and spouse’s) total current balance of cash, savings and checking accounts? Don’t include
student financial aid.
$
41. As of today, what is the net worth of your (and spouse’s) investments, including real estate? Don’t include the home you
live in. Net worth means current value minus debt. See Notes page 2.
$
42. As of today, what is the net worth of your (and spouse’s) current businesses and/or investment farms? Don’t include a
family farm or family business with 100 or fewer full-time or full-time equivalent employees. See Notes page 2.
$
For Help — 1-800-433-3243
Page 4
52
,
,
,
,
,
Step Two CONTINUED on page 5
Step Two CONTINUED from page 4
43. Student’s 2011 Additional Financial Information (Enter the combined amounts for you and your spouse.)
a. Education credits (American Opportunity, Hope or Lifetime Learning tax credits) from IRS Form 1040—line 49 or 1040A—line 31.
$
b. Child support paid because of divorce or separation or as a result of a legal requirement. Don’t include support for children in your
household, as reported in question 93.
$
c. Taxable earnings from need-based employment programs, such as Federal Work-Study and need-based employment portions of
fellowships and assistantships.
$
d. Taxable student grant and scholarship aid reported to the IRS in your adjusted gross income. Includes AmeriCorps benefits (awards,
living allowances and interest accrual payments), as well as grant and scholarship portions of fellowships and assistantships.
$
e. Combat pay or special combat pay. Only enter the amount that was taxable and included in your adjusted gross income. Don’t include
untaxed combat pay.
$
f. Earnings from work under a cooperative education program offered by a college.
$
,
,
,
,
,
,
44. Student’s 2011 Untaxed Income (Enter the combined amounts for you and your spouse.)
a. Payments to tax-deferred pension and savings plans (paid directly or withheld from earnings), including, but not limited to, amounts
reported on the W-2 forms in Boxes 12a through 12d, codes D, E, F, G, H and S.
$
b. IRA deductions and payments to self-employed SEP, SIMPLE, Keogh and other qualified plans from IRS Form 1040—line 28 + line 32
or 1040A—line 17.
$
c. Child support received for any of your children. Don’t include foster care or adoption payments.
$
d. Tax exempt interest income from IRS Form 1040—line 8b or 1040A—line 8b.
$
e. Untaxed portions of IRA distributions from IRS Form 1040—lines (15a minus 15b) or 1040A—lines (11a minus 11b). Exclude rollovers.
If negative, enter a zero here.
$
f. Untaxed portions of pensions from IRS Form 1040—lines (16a minus 16b) or 1040A—lines (12a minus 12b). Exclude rollovers.
If negative, enter a zero here.
$
g. Housing, food and other living allowances paid to members of the military, clergy and others (including cash payments and cash value
of benefits). Don’t include the value of on-base military housing or the value of a basic military allowance for housing.
$
h. Veterans noneducation benefits, such as Disability, Death Pension, or Dependency & Indemnity Compensation (DIC) and/or VA
Educational Work-Study allowances.
$
i. Other untaxed income not reported in items 44a through 44h, such as workers’ compensation, disability, etc. Also include the first-time
homebuyer tax credit from IRS Form 1040—line 67. Don’t include student aid, earned income credit, additional child tax credit, welfare
payments, untaxed Social Security benefits, Supplemental Security Income, Workforce Investment Act educational benefits, on-base
military housing or a military housing allowance, combat pay, benefits from flexible spending arrangements (e.g., cafeteria plans),
foreign income exclusion or credit for federal tax on special fuels.
,
,
,
,
,
,
,
,
$
,
$
,
j. Money received, or paid on your behalf (e.g., bills), not reported elsewhere on this form.
Step Three (Student):
Answer the questions in this step to determine if you will need to provide parental information. Once
you answer “Yes” to any of the questions in this step, skip Step Four and go to Step Five on page 8.
45. Were you born before January 1, 1989? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
1
No
2
46. As of today, are you married? (Also answer “Yes” if you are separated but not divorced.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
1
No
2
47. At the beginning of the 2012-2013 school year, will you be working on a master’s or doctorate program (such as an MA,
MBA, MD, JD, PhD, EdD, graduate certificate, etc.)?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
48. Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training? See Notes page 2. . . . .
Yes
1
No
2
Yes
1
No
2
49. Are you a veteran of the U.S. Armed Forces? See Notes page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
1
No
2
50. Do you have children who will receive more than half of their support from you between July 1, 2012 and June 30, 2013? . . .
Yes
1
No
2
Yes
1
No
2
51. Do you have dependents (other than your children or spouse) who live with you and who receive more than half of their
support from you, now and through June 30, 2013? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
52. At any time since you turned age 13, were both your parents deceased, were you in foster care or were you a dependent
or ward of the court? See Notes page 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
1
No
2
53. As determined by a court in your state of legal residence, are you or were you an emancipated minor? See Notes page 9. . . . .
Yes
1
No
2
54. As determined by a court in your state of legal residence, are you or were you in legal guardianship? See Notes page 9. . . . .
Yes
1
No
2
55. At any time on or after July 1, 2011, did your high school or school district homeless liaison determine that you were an
unaccompanied youth who was homeless? See Notes page 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
1
No
2
Yes
1
No
2
Yes
1
No
2
56. At any time on or after July 1, 2011, did the director of an emergency shelter or transitional housing program funded by
the U.S. Department of Housing and Urban Development determine that you were an unaccompanied youth who was
homeless? See Notes page 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
57. At any time on or after July 1, 2011, did the director of a runaway or homeless youth basic center or transitional living
program determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of
being homeless? See Notes page 9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For Help — www.studentaid.ed.gov/completefafsa
Page 5
53
If you (the student) answered “No” to every question in Step Three, go to Step Four.
If you answered “Yes” to any question in Step Three, skip Step Four and go to Step Five on page 8.
(Health professions students: Your college may require you to complete Step Four even if you answered “Yes” to any Step Three question.)
If you believe that you are unable to provide parental information, see Notes page 9.
Step Four (Parent): Complete this step if you (the student)
answered “No” to all questions in Step Three.
Answer all the questions in Step Four even if you do not live with your parents. Grandparents, foster parents, legal guardians, aunts and uncles are not considered parents
on this form unless they have legally adopted you. If your parents are living and married to each other, answer the questions about them. If your parent is single, widowed,
divorced, separated or remarried, see the Notes on page 9 for additional instructions.
58. What is your parents’ marital status as of today?
Married or remarried . . . . . .
1
Divorced or separated. . . . . . .
3
Single . . . . . . . . . . . . . . . . . . . .
2
Widowed . . . . . . . . . . . . . . . . . . .
4
59. Month and year
they were married,
remarried, separated,
divorced or widowed.
MONTH
YEAR
What are the Social Security Numbers, names and dates of birth of the parents reporting information on this form?
If your parent does not have a Social Security Number, you must enter 000-00-0000. If the name includes a suffix, such as Jr. or III, include a space between the last name and
suffix. Enter two digits for each day and month (e.g., for May 31, enter 05 31).
60. FATHER’S/STEPFATHER’S SOCIAL SECURITY NUMBER
–
62. FIRST INITIAL 63. FATHER’S/STEPFATHER’S DATE OF BIRTH
–
1 9
,
64. MOTHER’S/STEPMOTHER’S SOCIAL SECURITY NUMBER
–
61. FATHER’S/STEPFATHER’S LAST NAME, AND
65. MOTHER’S/STEPMOTHER’S LAST NAME, AND
66. FIRST INITIAL 67. MOTHER’S/STEPMOTHER’S DATE OF BIRTH
–
1 9
,
68. Your parents’ e-mail address. If you provide your parents’ e-mail address, we will let them know your FAFSA has been processed. This e-mail address will
also be shared with your state and the colleges listed on your FAFSA to allow them to electronically communicate with your parents.
@
69. What is your
parents’ state of
legal residence?
STATE
70. Did your parents become
legal residents of this state
before January 1, 2007?
Yes
1
No
2
71. If the answer to question 70 is “No,” give the
month and year legal residency began for the
parent who has lived in the state the longest.
MONTH
YEAR
72. How many people are in your parents’ household?
Include:
• yourself, even if you don’t live with your parents,
• your parents,
• your parents’ other children if (a) your parents will provide more than half of their support between July 1, 2012 and June 30, 2013, or
(b) the children could answer “No” to every question in Step Three on page 5 of this form, and
• other people if they now live with your parents, your parents provide more than half of their support and your parents will continue to
provide more than half of their support between July 1, 2012 and June 30, 2013.
73. How many people in your parents’ household (from question 72) will be college students between July 1, 2012 and June 30, 2013?
Always count yourself as a college student. Do not include your parents. You may include others only if they will attend, at least half-time in 20122013, a program that leads to a college degree or certificate.
In 2010 or 2011, did you, your parents or anyone in your parents’ household (from question 72) receive benefits from any of the federal programs listed?
Mark all that apply. Answering these questions will not reduce eligibility for student aid or these programs. Supplemental Nutrition Assistance Program (SNAP) is the new
name for Food Stamps. SNAP, Food Stamps and/or TANF may have a different name in your parents’ state. Call 1-800-4-FED-AID to find out the name of the state’s program.
74. Supplemental
Security
Income (SSI)
75. Food
Stamps
76. Free or
Reduced
Price Lunch
77. Temporary Assistance
for Needy Families
(TANF)
79. For 2011, have your parents completed their IRS income tax return or
another tax return listed in question 80?
My parents have already completed their return. . . . . . . . . . . . . . . . . . . .
1
My parents will file but have not yet completed their return . . . . . . . .
2
3
My parents are not going to file. Skip to question 86. . . . . . . . . . . . . .
81. If your parents have filed or will file a 1040,
were they eligible to file a 1040A or 1040EZ?
See Notes page 2.
For Help — 1-800-433-3243
Yes
1
No
2
Don’t know
3
78. Special Supplemental
Nutrition Program for Women,
Infants and Children (WIC)
80. What income tax return did your parents file or will they file for 2011?
IRS 1040 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
IRS 1040A or 1040EZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
A foreign tax return. See Notes page 2. . . . . . . . . . . . . . . . . . . . . . . . . . .
3
A tax return with Puerto Rico, another U.S. territory or Freely
Associated State. See Notes page 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
82. As of today, is either of your parents a
dislocated worker? See Notes page 9.
Page 6
54
Yes
1
No
2
Don’t know
3
Step Four CONTINUED on page 7
Step Four CONTINUED from page 6
For questions 83–92, if the answer is zero or the question does not apply, enter 0. Report whole dollar amounts with no cents.
83. What was your parents’ adjusted gross income for 2011? Adjusted gross income is on IRS Form 1040—line 37;
1040A—line 21; or 1040EZ—line 4.
$
84. Enter your parents’ income tax for 2011. Income tax amount is on IRS Form 1040—line 55; 1040A—line 35; or
1040EZ—line 10.
$
,
,
85. Enter your parents’ exemptions for 2011. Exemptions are on IRS Form 1040—line 6d or on Form 1040A—line 6d.
For Form 1040EZ, see Notes page 2.
Questions 86 and 87 ask about earnings (wages, salaries, tips, etc.) in 2011. Answer the questions whether or not a tax return was filed. This information may be on the W-2
forms, or on IRS Form 1040—lines 7 + 12 + 18 + Box 14 (Code A) of IRS Schedule K-1 (Form 1065); on 1040A—line 7; or on 1040EZ—line 1. If any individual earning item is
negative, do not include that item in your calculation.
86. How much did your father/stepfather earn from working in 2011?
$
87. How much did your mother/stepmother earn from working in 2011?
$
88. As of today, what is your parents’ total current balance of cash, savings and checking accounts?
$
89. As of today, what is the net worth of your parents’ investments, including real estate? Don’t include the home in which
your parents live. Net worth means current value minus debt. See Notes page 2.
$
90. As of today, what is the net worth of your parents’ current businesses and/or investment farms? Don’t include a family
farm or family business with 100 or fewer full-time or full-time equivalent employees. See Notes page 2.
$
91. Parents’ 2011 Additional Financial Information (Enter the amounts for your parent[s].)
a. Education credits (American Opportunity, Hope or Lifetime Learning tax credits) from IRS Form 1040—line 49 or 1040A—line 31.
,
,
,
,
,
$
b. Child support paid because of divorce or separation or as a result of a legal requirement. Don’t include support for children in your
parents’ household, as reported in question 72.
$
c. Your parents’ taxable earnings from need-based employment programs, such as Federal Work-Study and need-based employment
portions of fellowships and assistantships.
$
d. Your parents’ taxable student grant and scholarship aid reported to the IRS in your parents’ adjusted gross income. Includes
AmeriCorps benefits (awards, living allowances and interest accrual payments), as well as grant and scholarship portions of fellowships
and assistantships.
$
e. Combat pay or special combat pay. Only enter the amount that was taxable and included in your parents’ adjusted gross income.
Do not enter untaxed combat pay.
$
f. Earnings from work under a cooperative education program offered by a college.
$
,
,
,
,
,
,
92. Parents’ 2011 Untaxed Income (Enter the amounts for your parent[s].)
a. Payments to tax-deferred pension and savings plans (paid directly or withheld from earnings), including, but not limited to, amounts
reported on the W-2 forms in Boxes 12a through 12d, codes D, E, F, G, H and S.
$
b. IRA deductions and payments to self-employed SEP, SIMPLE, Keogh and other qualified plans from IRS Form 1040—line 28 + line 32 or
1040A—line 17.
$
c. Child support received for any of your parents’ children. Don’t include foster care or adoption payments.
d. Tax exempt interest income from IRS Form 1040—line 8b or 1040A—line 8b.
$
$
e. Untaxed portions of IRA distributions from IRS Form 1040—lines (15a minus 15b) or 1040A—lines (11a minus 11b). Exclude rollovers.
If negative, enter a zero here.
$
f. Untaxed portions of pensions from IRS Form 1040—lines (16a minus 16b) or 1040A—lines (12a minus 12b). Exclude rollovers.
If negative, enter a zero here.
$
g. Housing, food and other living allowances paid to members of the military, clergy and others (including cash payments and cash value
of benefits). Don’t include the value of on-base military housing or the value of a basic military allowance for housing.
$
h. Veterans noneducation benefits, such as Disability, Death Pension, or Dependency & Indemnity Compensation (DIC) and/or VA
Educational Work-Study allowances.
$
i. Other untaxed income not reported in items 92a through 92h, such as workers’ compensation, disability, etc. Also include the firsttime homebuyer tax credit from IRS Form 1040—line 67. Don’t include student aid, earned income credit, additional child tax
credit, welfare payments, untaxed Social Security benefits, Supplemental Security Income, Workforce Investment Act educational
benefits, on-base military housing or a military housing allowance, combat pay, benefits from flexible spending arrangements
(e.g., cafeteria plans), foreign income exclusion or credit for federal tax on special fuels.
$
For Help — www.studentaid.ed.gov/completefafsa
Page 7
55
,
,
,
,
,
,
,
,
,
Step Five (Student): Complete this step only if you (the student) answered “Yes” to any questions in Step Three.
93. How many people are in your household?
Include:
• yourself (and your spouse),
• your children, if you will provide more than half of their support between July 1, 2012 and June 30, 2013, and
• other people if they now live with you, you provide more than half of their support and you will continue to provide more than half of their
support between July 1, 2012 and June 30, 2013.
94. How many people in your (and your spouse’s) household (from question 93) will be college students between July 1, 2012 and
June 30, 2013? Always count yourself as a college student. Include others only if they will attend, at least half-time in 2012-2013, a program that
leads to a college degree or certificate.
In 2010 or 2011, did you (or your spouse) or anyone in your household (from question 93) receive benefits from any of the federal programs listed?
Mark all that apply. Answering these questions will not reduce eligibility for student aid or these programs. Supplemental Nutrition Assistance Program (SNAP) is the
new name for Food Stamps. SNAP, Food Stamps and/or TANF may have a different name in your state. Call 1-800-4-FED-AID to find out the name of the state’s program.
95. Supplemental
Security
Income (SSI)
96. Food
Stamps
97. Free or
Reduced
Price Lunch
99. Special Supplemental Nutrition
Program for Women, Infants
and Children (WIC)
98. Temporary Assistance
for Needy Families
(TANF)
Yes
100. As of today, are you (or your spouse) a dislocated worker? See Notes page 9.
1
No
Don’t know
2
3
Step Six (Student): Indicate which colleges you want to receive your FAFSA information.
Enter the six-digit federal school code and your housing plans. You can find the school codes at www.fafsa.gov or by calling 1-800-4-FED-AID. If you
cannot get the code, write in the complete name, address, city and state of the college. For state aid, you may wish to list your preferred college first. To
find out how to have more colleges receive your FAFSA information, read What is the FAFSA? on page 10.
1ST FEDERAL SCHOOL CODE
101. a
OR
2ND FEDERAL SCHOOL CODE
101. c
OR
3RD FEDERAL SCHOOL CODE
101. e
OR
4TH FEDERAL SCHOOL CODE
101. g
OR
HOUSING PLANS
STATE
NAME OF
COLLEGE
101. b on campus
ADDRESS
AND CITY
STATE
NAME OF
COLLEGE
ADDRESS
AND CITY
101. d
STATE
NAME OF
COLLEGE
ADDRESS
AND CITY
101. f
STATE
NAME OF
COLLEGE
ADDRESS
AND CITY
101. h
1
with parent
2
off campus
3
on campus
1
with parent
2
off campus
3
on campus
1
with parent
2
off campus
3
on campus
1
with parent
2
off campus
3
Step Seven (Student and Parent): Read, sign and date.
If you are the student, by signing this application you certify that you (1) will use federal
and/or state student financial aid only to pay the cost of attending an institution of higher
education, (2) are not in default on a federal student loan or have made satisfactory
arrangements to repay it, (3) do not owe money back on a federal student grant or have
made satisfactory arrangements to repay it, (4) will notify your college if you default on a
federal student loan and (5) will not receive a Federal Pell Grant from more than one college
for the same period of time.
If you are the parent or the student, by signing this application you agree, if asked, to
provide information that will verify the accuracy of your completed form. This information
may include U.S. or state income tax forms that you filed or are required to file. Also, you
certify that you understand that the Secretary of Education has the authority to verify
information reported on this application with the Internal Revenue Service and other
federal agencies. If you sign any document related to the federal student aid programs
electronically using a personal identification number (PIN), you certify that you are the
person identified by the PIN and have not disclosed that PIN to anyone else. If you purposely
give false or misleading information, you may be fined up to $20,000, sent to prison, or both.
If you or your family paid a fee for someone to
fill out this form or to advise you on how to fill it
out, that person must complete this part.
104. Preparer’s Social Security Number (or 105)
Preparer’s name, firm and address
105. Employer ID number (or 104)
–
102. Date this form was completed
MONTH
DAY
2012
or
2013
103. Student (Sign below)
1
Parent (A parent from Step Four sign below.)
2
COLLEGE USE ONLY
–
D/O
1
FEDERAL SCHOOL CODE
Homeless
Youth
Determination
4
FAA Signature
–
1
106. Preparer’s signature and date
DATA ENTRY
USE ONLY:
1
For Help — 1-800-433-3243
Page 8
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P
*
L
E
Notes for question 52 (page 5)
Notes for Step Four, questions 58–92 (pages 6 and 7)
Answer “Yes” if at any time since you turned age 13:
• You had no living parent (biological or adoptive), even if you are now
adopted; or
Additional instructions about who is considered a parent on this form:
• If your parent is widowed or single, answer the questions about that
parent.
• You were in foster care, even if you are no longer in foster care today;
or
• If your widowed parent is remarried as of today, answer the questions
about that parent and your stepparent.
• You were a dependent or ward of the court, even if you are no longer
a dependent or ward of the court today. For federal student aid
purposes, someone who is incarcerated is not considered a ward of
the court.
• If your parents are divorced or separated, answer the questions about
the parent you lived with more during the past 12 months. (If you did
not live with one parent more than the other, give answers about
the parent who provided more financial support during the past 12
months, or during the most recent year that you actually received
support from a parent.) If this parent is remarried as of today, answer
the questions about that parent and your stepparent.
The financial aid administrator at your school may require you to provide
proof that you were in foster care or a dependent or ward of the court.
Notes for questions 53 and 54 (page 5)
Notes for questions 82 (page 6)
and 100 (page 8)
The definition of legal guardianship does not include your parents, even
if they were appointed by a court to be your guardians. You are also not
considered a legal guardian of yourself.
In general, a person may be considered a dislocated worker if he or she:
• is receiving unemployment benefits due to being laid off or losing a
job and is unlikely to return to a previous occupation;
Answer “Yes” if you can provide a copy of a court’s decision that as of
today you are an emancipated minor or are in legal guardianship. Also
answer “Yes” if you can provide a copy of a court’s decision that you were
an emancipated minor or were in legal guardianship immediately before
you reached the age of being an adult in your state. The court must be
located in your state of legal residence at the time the court’s decision
was issued.
• has been laid off or received a lay-off notice from a job;
• was self-employed but is now unemployed due to economic
conditions or natural disaster; or
• is a displaced homemaker. A displaced homemaker is generally a
person who previously provided unpaid services to the family (e.g., a
stay-at-home mom or dad), is no longer supported by the husband or
wife, is unemployed or underemployed, and is having trouble finding
or upgrading employment.
Answer “No” if you are still a minor and the court decision is no longer
in effect or the court decision was not in effect at the time you became
an adult.
If a person quits work, generally he or she is not considered a dislocated
worker even if, for example, the person is receiving unemployment
benefits.
The financial aid administrator at your college may require you to provide
proof that you were an emancipated minor or in legal guardianship.
Notes for questions 55–57 (page 5)
Answer “Yes” to question 82 if your parent is a dislocated worker. Answer
“Yes” to question 100 if you or your spouse is a dislocated worker.
Answer “Yes” if you received a determination at any time on or after
July 1, 2011, that you were an unaccompanied youth who was homeless
or, for question 57, at risk of being homeless.
Answer “No” to question 82 if your parent is not a dislocated worker.
Answer “No” to question 100 if neither you nor your spouse is a dislocated
worker.
• “Homeless” means lacking fixed, regular and adequate housing. You
may be homeless if you are living in shelters, parks, motels or cars, or
are temporarily living with other people because you have nowhere
else to go. Also, if you are living in any of these situations and fleeing
an abusive parent you may be considered homeless even if your
parent would provide support and a place to live.
Answer “Don’t know” to question 82 if you are not sure whether your
parent is a dislocated worker. Answer “Don’t know” to question 100 if
you are not sure whether you or your spouse is a dislocated worker. You
can contact your financial aid office for assistance in answering these
questions.
• “Unaccompanied” means you are not living in the physical custody
of your parent or guardian.
The financial aid administrator at your college may require you to
provide proof that your parent is a dislocated worker, if you answered
“Yes” to question 82, or that you or your spouse is a dislocated worker, if
you answered “Yes” to question 100.
• “Youth” means you are 21 years of age or younger or you are still
enrolled in high school as of the day you sign this application.
Answer “No” if you are not homeless or at risk of being homeless, or do
not have a determination. You should contact your financial aid office
for assistance if you do not have a determination but believe you are an
unaccompanied youth who is homeless or are an unaccompanied youth
providing for your own living expenses who is at risk of being homeless.
The financial aid administrator at your college may require you to
provide a copy of the determination if you answered “Yes” to any of
these questions.
Notes for students unable to provide parental information on
pages 6 and 7
Under very limited circumstances (for example, your parents are
incarcerated; you have left home due to an abusive family environment;
or you do not know where your parents are and are unable to contact
them), you may be able to submit your FAFSA without parental
information. If you are unable to provide parental information, skip
Steps Four and Five, and go to Step Six. Once you submit your FAFSA
without parental data, you must follow up with the financial aid office
at the college you plan to attend, in order to complete your FAFSA.
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57
What is the FAFSA ?
Information on the Privacy Act and use of your
Social Security Number
Why fill out a FAFSA?
We use the information that you provide on this form to determine if you are
eligible to receive federal student financial aid and the amount that you are
eligible to receive. Sections 483 and 484 of the Higher Education Act of 1965,
as amended, give us the authority to ask you and your parents these questions,
and to collect the Social Security Numbers of you and your parents. We use your
Social Security Number to verify your identity and retrieve your records, and we
may request your Social Security Number again for those purposes.
SM
The Free Application for Federal Student Aid (FAFSA) is the first step in the
financial aid process. You use the FAFSA to apply for federal student aid, such
as grants, loans and work-study. In addition, most states and colleges use
information from the FAFSA to award nonfederal aid.
Why all the questions?
The questions on the FAFSA are required to calculate your Expected Family
Contribution (EFC). The EFC measures your family’s financial strength and is
used to determine your eligibility for federal student aid. Your state and the
colleges you list may also use some of your responses. They will determine if
you may be eligible for school or state aid, in addition to federal aid.
State and institutional student financial aid programs may also use the
information that you provide on this form to determine if you are eligible to
receive state and institutional aid and the need that you have for such aid.
Therefore, we will disclose the information that you provide on this form to
each institution you list in questions 101a - 101h, state agencies in your state of
legal residence and the state agencies of the states in which the colleges that
you list in questions 101a - 101h are located.
How do I find out what my Expected Family Contribution (EFC) is?
Your EFC will be listed on your Student Aid Report (SAR). Your SAR summarizes
the information you submitted on your FAFSA. It is important to review your SAR
to make sure all of your information is correct and complete. Make corrections
or provide additional information, as necessary.
How much aid will I receive?
If you are applying solely for federal aid, you must answer all of the following
questions that apply to you: 1-9, 14-16, 18, 21-23, 26, 28-29, 32-36, 38-58, 60-67,
69, 72-84, 86-100, 102-103. If you do not answer these questions, you will not
receive federal aid.
Using the information on your FAFSA and your EFC, the financial aid office at
your college will determine the amount of aid you will receive. The college will
use your EFC to prepare a financial aid package to help you meet your financial
need. Financial need is the difference between your EFC and your college’s
cost of attendance (which can include living expenses), as determined by
the college. If you or your family have unusual circumstances that should be
taken into account, contact your college’s financial aid office. Some examples
of unusual circumstances are: unusual medical or dental expenses or a large
change in income from last year to this year.
Without your consent, we may disclose information that you provide to entities
under a published “routine use.” Under such a routine use, we may disclose
information to third parties that we have authorized to assist us in administering
the above programs; to other federal agencies under computer matching
programs, such as those with the Internal Revenue Service, Social Security
Administration, Selective Service System, Department of Homeland Security,
Department of Justice and Veterans Affairs; to your parents or spouse; and to
members of Congress if you ask them to help you with student aid questions.
When will I receive the aid?
If the federal government, the U.S. Department of Education, or an employee
of the U.S. Department of Education is involved in litigation, we may send
information to the Department of Justice, or a court or adjudicative body, if the
disclosure is related to financial aid and certain conditions are met. In addition,
we may send your information to a foreign, federal, state, or local enforcement
agency if the information that you submitted indicates a violation or potential
violation of law, for which that agency has jurisdiction for investigation
or prosecution. Finally, we may send information regarding a claim that is
determined to be valid and overdue to a consumer reporting agency. This
information includes identifiers from the record; the amount, status and history
of the claim; and the program under which the claim arose.
Any financial aid you are eligible to receive will be paid to you through your
college. Typically, your college will first use the aid to pay tuition, fees and room
and board (if provided by the college). Any remaining aid is paid to you for your
other educational expenses. If you are eligible for a Federal Pell Grant, you may
receive it from only one college for the same period of enrollment.
How can I have more colleges receive my FAFSA information?
If you are completing a paper FAFSA, you can only list four colleges in the
school code step. You may add more colleges by doing one of the following:
1. Use the Federal Student Aid PIN you will receive after your FAFSA has been
processed and go to FAFSA on the Web at www.fafsa.gov. Click the “Start
Here” button to log in and then select the “Make FAFSA Corrections” link.
State Certification
2. Use the Student Aid Report (SAR), which you will receive after your FAFSA is
processed. Your Data Release Number (DRN) verifies your identity and will
be listed on the first page of your SAR. You can call 1-800-4-FED-AID and
provide your DRN to a customer service representative, who will add more
school codes for you.
By submitting this application, you are giving your state financial aid agency
permission to verify any statement on this form and to obtain income tax
information for all persons required to report income on this form.
3. Provide your DRN to the financial aid administrator at the college you want
added, and he or she can add their school code to your FAFSA.
The Paperwork Reduction Act of 1995 says that no one is required to respond to
a collection of information unless it displays a valid OMB control number, which
for this form is 1845-0001. The time required to complete this form is estimated
to be three hours, including time to review instructions, search data resources,
gather the data needed, and complete and review the information collection.
If you have comments about this estimate or suggestions for improving this
form, please write to:
The Paperwork Reduction Act of 1995
Note: Your FAFSA record can only list up to ten school codes. If there are ten
school codes on your record, any new school codes that you add will replace
one or more of the school codes listed.
Where can I receive more information on student aid?
The best place for information about student financial aid is the financial aid
office at the college you plan to attend. The financial aid administrator can tell
you about student aid available from your state, the college itself and other
sources.
• You can also visit our web site www.studentaid.ed.gov.
• For information by phone you can call our Federal Student Aid Information
Center at 1-800-4-FED-AID (1-800-433-3243). TTY users (for the hearing
impaired) may call 1-800-730-8913.
• You can also check with your high school counselor, your state aid agency
or your local library’s reference section.
U.S. Department of Education, Washington, DC 20202-4700.
We may request additional information from you to process your application
more efficiently. We will collect this additional information only as needed and
on a voluntary basis.
Information about other nonfederal assistance may be available from foundations,
religious organizations, community organizations and civic groups, as well as
organizations related to your field of interest, such as the American Medical
Association or American Bar Association. Check with your parents’ employers or
unions to see if they award scholarships or have tuition payment plans.
Page 10
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Appendix F
Electronic Announcement, Feb. 24, 2012.
Posted Date: February 24, 2012
Author: David Bergeron, Deputy Assistant Secretary for Policy, Planning, and Innovation
Subject: 2012-13 FAFSA Verification-IRS Tax Return Transcript Matrix
In the February 3, 2012 electronic announcement that released sample2012-2013
verification worksheets, we noted that we would be developing and releasing a 2012-13
FAFSA Verification-IRS Tax Return Transcript Matrix. The matrix is provided as an
attachment to this electronic announcement. The matrix will help financial aid
administrators understand how to verify IRS income and tax information when an IRS
Tax Return Transcript has been submitted by the student or parent. It will also clarify
how the items on the IRS Tax Return Transcript relate to the items on the FAFSA and
ISIR, as the transcript does not have line or item numbers and uses wording that may be
different than that used on the FAFSA and ISIR for some items.
The first column of the matrix lists the seven FAFSA information items that may need to
be verified for a student or parent who indicated that they did or will file a 2011 IRS tax
return. The second column includes the student FAFSA question number for each item
followed by the relevant parent FAFSA question number. The third column displays the
student ISIR item number followed by the parent ISIR item number. ISIR numbers are
from the 2012-2013 Electronic Data Exchange (EDE).
The fourth column of the matrix identifies the item name as reported on the IRS Tax
Return Transcript. Note that for some items the transcript may report two or three
values. This is because the IRS calculates or recalculates the amount reported by the
tax filer for some items. If only one value is reported on the transcript that value must be
used for verification. If more than one value is reported on the transcript, the value
associated with the item name that includes the words “Per Computer” must be used for
verification. The “Per Computer” line should be used for verification even if it is different
than what was reported by the tax filer.
The last three columns show the corresponding line item numbers from the three 2011
IRS tax returns (IRS Form 1040, IRS Form 1040A, and IRS Form 1040EZ).
59
If you have any questions about the attached matrix, please contact our Research and
Customer Care Center staff. Staff are available Monday through Friday between the
hours of 9:00 AM and 5:00 PM (Eastern Time) at 1-800-433-7327. After hours calls will
be accepted by an automated voice response system. Callers leaving their names and
phone numbers will receive a return call the next business day. Alternatively, you may
email the Care Center at fsa.customer.support@ed.gov.
2012-13 FAFSA Verification-IRS Tax Return Transcript Matrix in Microsoft Excel Format
Plugins & Viewers
FOIA
|
Privacy
|
Security
|
Notices
WhiteHouse.gov
60
|
USA.gov
|
ED.gov
Posted Date: March 16, 2012
Author: Jeff Baker, Director, Policy Liaison and Implementation, Federal Student Aid
Subject: Revised 2012-2013 FAFSA Verification - IRS Tax Return Transcript Matrix
On February 24, 2011, we posted an electronic announcement that included a 2012-13
FAFSA Verification-IRS Tax Return Transcript Matrix. The 2012-13 FAFSA VerificationIRS Tax Return Transcript Matrix was created to help financial aid administrators
understand how to verify IRS income and tax information when an IRS Tax Return
Transcript has been submitted by the parent or student.
Based upon new guidance received from the IRS, we are issuing a slightly revised 201213 FAFSA Verification-IRS Tax Return Transcript Matrix, as an attachment to this
electronic announcement. On the original February 24 matrix, under the “2011 IRS Tax
Return Transcript Item” column we directed financial aid administrators to use the
“Tentative Tax Per Computer” value from an IRS Form 1040A transcript to verify the
“Income Tax Paid” FAFSA item. The attached revised matrix now instructs financial aid
administrators to use the “Total Tax Liability TP Figures Per Computer” value from an
IRS Form 1040A transcript to verify the “Income Tax Paid” FAFSA item, as this value
correctly includes the tax credits that a tax filer may receive.
If you have any questions about the attached matrix, please contact our Research and
Customer Care Center staff. Staff are available Monday through Friday between the
hours of 9:00 AM and 5:00 PM (Eastern Time) at 1-800-433-7327. After hours calls will
be accepted by an automated voice response system. Callers leaving their names and
phone numbers will receive a return call the next business day. Alternatively, you may
email the Care Center at fsa.customer.support@ed.gov.
Attachments/Enclosures:
Revised 2012-2013 FAFSA Verification-IRS Tax Return Transcript Matrix in Microsoft
Excel Format, 38KB
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62
43aand91a
44band92b
44dand92d
44eand92e
EducationCredits
IRADeductionsandPayments
TaxExemptInterestIncome
UntaxedPortionsofIRADistributions
61and125
60and124
59and123
57and121
50and114
43and107
42and106
Notes
TotalPensionsandAnnuities–TaxablePension/AnnuityAmount
TotalIRADistributions–TaxableIRADistributions
TaxͲExemptInterest
KEOGH/SEPContributionDeduction+IRADeductionPerComputer
EducationCreditPerComputer
AdjustedGrossIncomePerComputer
ForIRSForm1040Transcripts:
—IncomeTaxAfterCreditsPerComputer
ForIRSForm1040ATranscripts:
—TentativeTaxPerComputer
ForIRSForm1040EZTranscripts:
—TotalTaxLiabilityTPFiguresPerComputer
2012–2013FAFSAVerificationͲIRSTaxReturnTranscriptMatrix
2012–2013ISIRField#
(StudentandParent)
2011IRSTaxReturnTranscriptItem
16a–16b
15a–15b
8b
28+32
N/A
N/A
11a–11b
12a–12b
N/A
N/A
N/A
10
4
2011IRS1040EZLine#
8b
17
31
35
55
49
21
2011IRS1040ALine#
37
2011IRS1040Line#
MarriedFilingSeparately—Anapplicantoranapplicant'sparent(s)whofiledorwillfilehisorherincometaxreturnas"MarriedFilingSeparately"orwhoismarriedtosomeoneotherthantheindividualincludedonajointincometax
returnmustprovideseparateIRSTaxReturnTranscriptsforeachpersonwhoseinformationisincludedontheFAFSA.
PerComputer—AvaluecalculatedbytheIRSthatispresentoncertainitemsofanIRSTaxReturnTranscript.ThePerComputeramountmustbeusedforverificationevenifitisdifferentthanwhatwasreportedbythetaxfilertotheIRS.
IRSTaxReturnTranscript—Showsmostlineitemsfromataxfiler'soriginaltaxreturn(Form1040,1040Aor1040EZ).AnIRSTaxReturnTranscriptdoesnotincludeanyinformationfromanamendedtaxreturn.
The2012–2013FAFSAVerificationͲIRSTaxReturnTranscriptMatrixisapplicableonlytoIRStaxfilers(IRSForm1040,1040A,and1040EZ)andincludesonlytheincomeinformationfortaxfilersrequiredbytheDepartmenttobe
verifiedfor2012–2013.
44fand92f
36and84
IncomeTaxPaid
UntaxedPortionsofPensions
35and83
2012–2013FAFSAQ#
(StudentandParent)
AdjustedGrossIncome
2012–2013FAFSAInformation
RequiringVerification
Appendix G
2012-2013 Application and Verification Guide, p. AVG-19
Ch. 2—Filling Out the FAFSA
Q Untaxed income (44 and 92). These questions total the untaxed
income, some of which is reported on the tax form even though it isn’t
taxed. A student who hasn’t filed a return will have to estimate these
amounts, and students or parents may need to separate information
from a joint return.
a. Payments to tax-deferred or sheltered pension and savings plans
(paid directly or withheld from earnings). This includes untaxed
portions of 401(k) and 403(b) plans. These types of payments are
listed in boxes 12a through 12d of the W-2 and will have one of the
following codes: D, E, F, G, H, or S. Note that employer contributions
to these plans shouldn’t be reported as an untaxed benefit.
b. Deductible IRA or Keogh payments. Payments to an IRA or
Keogh plan that are excluded from taxation are reported as untaxed
income. These amounts appear on the tax return.
c. Child support received for all children.
d. Tax-exempt interest income. Certain types of interest, such as
interest on municipal bonds, are tax-exempt. This amount is on line
8b on both the 1040 and 1040A forms.
e. and f. Untaxed IRA distributions and pension or annuity
payments. A tax filer determines how much of his IRA distribution
or pension or annuity payment is taxable when he completes his
tax return. The applicant reports the untaxed portion, which is
determined from the tax return, but should not include rollovers
(transfers of funds from one IRA to another).
STEP
2
Questions 44 and 92
Untaxed income
Health savings accounts
Health savings accounts (HSAs) resemble tax-deferred pension and savings
plans more than flexible spending arrangements; for example, the balance in
an HSA persists from year to year, while
that in a flexible spending arrangement
must be spent on qualified expenses by
the end of the year. Therefore, treat taxfree contributions to an HSA as untaxed
income. The balance in the account
does not count as an asset, nor would
distributions from it count as untaxed
income when they are used for qualified medical expenses. If distributions
are not used for qualified expenses,
they are subject to income tax (and a
possible penalty) and will be counted in
the adjusted gross income.
Homebuyer tax credit
g. Housing, food, and other living allowances. Some people,
particularly clergy and military personnel, receive these allowances as
compensation for their jobs. Money received to pay for rent should
also be reported, as should the free use of a house or apartment (the
rent or market value of a comparable house or apartment can be
used). Similarly, if the student received free room or board in 2011
for a job that was not awarded as student financial aid (including
resident advisor positions that provide free room and board as part of
the student’s non-need-based employment compensation), she must
report the value of the room and board as untaxed income. Note the
housing exclusions on the following page.
This is $6,500 or $8,000 (these are maximum amounts) for long-time residents
or first-time homebuyers respectively,
though for 2011 tax returns the credit is
only available to filers and their spouses
who were on qualified duty outside the
United States in the military, the foreign
service, or with the intelligence community. Because the credit is not explicitly
excluded by law from the need analysis,
as are other credits, it counts as untaxed
income. Since there is a documentation
requirement, a person must file a paper
return to claim the credit.
h. Veterans’ noneducation benefits. This includes disability, the
death pension, Dependency and Indemnity Compensation (DIC), and
Veterans Affairs (VA) educational work-study allowances.
Independent student with
parental support example
i. Any other untaxed income not reported elsewhere. This can
include disability, worker’s compensation, interest income on
education IRAs, untaxed portions of Railroad Retirement benefits,
black lung benefits, refugee assistance, the untaxed portion of capital
gains, and foreign income that wasn’t taxed by any government and
isn’t part of the Foreign Earned Income Exclusion.
Doug is a graduate student, so he’s
independent even though he still lives
with his parents and has no income of
his own. Although the FAA at his school
can’t make him a dependent student,
she can decide to use professional judgment to add an amount to his untaxed
income to account for the in-kind support his parents provide.
FSA HB MAR 2012
AVG–19
63