2017-2018
Return signed and completed form via:
Email: [email protected] Fax: 817-272-3555
Mail: P.O. Box 19199, Arlington, TX 76019
In Person: Davis Hall, Room 252
2017-2018 Verification of Income
Name:
Maverick ID:
You and/or your parents indicated on your FAFSA that you did not file a tax return. Please complete the form as follows:
• Independent students – please complete Section 1 ONLY and sign.
• Dependent students – please complete Section 1 and 2 and sign. Parent signature is required.
Section 1 – Student/Spouse
Complete this section if the student and/or spouse will not file and are not required to file a 2015 income tax return with the
IRS.
Please check the box that applies:


Neither the student nor the student’s spouse (if applicable) was employed nor had any income earned from work in
2015.
You and/or your spouse were employed in 2015. List below the names of all employers, the amount earned
from each employer in 2015, and indicate whether an IRS W-2 form is provided.
Please provide copies of all 2015 IRS W-2 forms issued to you and/or your spouse by your employers.
List each employer even if the employer did not issue an IRS W-2 form.
Employer Name
2015 Income
Earned
$
$
$
$

W-2 received and
attached
YES / NO
YES / NO
YES / NO
YES / NO
You and/or your spouse did file a 2015 Federal Tax Return and do not need to complete this form.
Please submit a 2015 IRS Tax Return Transcript to the Financial Aid Office.
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2017-2018
2017-2018
Section 2 - Parent
The instructions and certifications below apply to each parent included in the household as reported on your 2017-2018
FAFSA. Complete this section if the parents will not file and are not required to file a 2015 income tax return with the IRS.
Please check the box that applies:

Neither parent was employed nor had any income earned from work in 2015.

One or both parents were employed in 2015. List below the names of all employers, the amount earned from
each employer in 2015, and indicate whether an IRS W-2 form is provided.
Please provide copies of all 2015 IRS W-2 forms issued to the parents by their employers. List each
employer even if the employer did not issue an IRS W-2 form.
Employer Name
2015 Income
Earned
$
$
$
$

W-2 received and
attached
YES / NO
YES / NO
YES / NO
YES / NO
One or both parents filed a 2015 Federal Tax Return and do not need to complete this form.
Please submit a 2015 IRS Tax Return Transcript to the Financial Aid Office.
Certification and Signature
I certify that all of the information reported is complete and correct, and that there is no forgery of signature(s). I understand that I must
sign and return this form for my financial aid to be processed. Electronic signatures are not accepted.
____________________________________
Student Signature (Required)
_____________
Date
____________________________________
Parent Signature (Required if Dependent)
_____________
Date
2017-2018