Harvard College Griffin Financial Aid Office
86 Brattle Street Cambridge MA 02138
(p) 617.495.1581 / (f) 617.496.0256
(e) faoinfo@fas.harvard.edu
Verification of Non-Filer Status
2015-2016
Student Information
Student Name:
Class of:
HUID:
If you or your parent(s) did not and were not required to file a 2014
Federal Income Tax Return, please complete the following information and
submit this form, along with any W-2 forms.
Each non-filer must complete a separate statement.
I, _______________________________________, verify that I did not and was not required to file a
Federal Income Tax Return with the IRS for the year 2014. The amounts and sources of my income are
listed below. All information on the financial aid application materials that will be used to calculate my
(child’s) federal aid eligibility is complete and correct.
Social Security
$
AFDC
$
Pension/IRA
$
Child Support Received
$
W2 Income (wages)
$
Other (explain)
$
$
TOTAL $
By signing, I certify that all the information reported is complete and correct.
Signature (of non-filer)
Date
This form is required in compliance with the verification process of the U.S. Department of Education’s Federal Student Aid
Programs. Failure to complete the form may result in the withdrawal of federal aid. Knowingly false or misleading information
submitted on this form is punishable by a fine and/or jail time.