Tax Information
The best way to verify income is by using the IRS Data Retrieval Tool that is part of the FAFSA on the web. If you have not already
used the tool, go to FAFSA.gov, log in to your FAFSA record, select “Make FAFSA corrections,” and navigate to the Financial
Information section of the form. If you filed electronically, the IRS will provide your information within 2 weeks; if you filed by
paper, it may take up to 8 weeks for your information to be uploaded via the IRS Data Retrieval Tool on the FAFSA. If you are not
eligible to use the IRS Data Retrieval Tool, you will need to request an IRS Tax Return Transcript by calling 800-908-9946 or online
at www.irs.gov/transcript. We cannot accept Federal Income Tax Returns and they will be destroyed if received.
Non Filers
If you did not file a federal tax return, you will need to submit the Verification of Non-filing letter as well as the Wage and Income
transcript. You will need to request the IRS Verification of Non-Filing letter and the IRS Wage and Income transcript by calling 800908-9946 or online at www.irs.gov/transcript. The Verification of Non-filing letter will not be available until June 16, 2016.
Students may complete a Student Non-Filer Statement form to satisfy this requirement found on www.savannahstate.edu;
Current Students; Financial Aid; Forms & Documents.
Individuals Who Filed an Amended IRS Income Tax Return
If you filed an amended IRS income tax return for tax year 2015, provide an IRS Account Transcript that lists tax filer information for
the tax year 2015; and a signed copy of the 2015 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was filed
with the IRS.
Individuals who were victims of IRS Identity Theft
If you are victim of IRS identity theft you must complete the 2016-17 Student (or Parent) Statement of IRS Tax Related Identity Theft
Form. You will need to attach the Tax Return DataBase View (TRDBV) transcript obtained from the IRS. Tax filers may obtain a
TRDBV transcript and inform the IRS of the tax-related identity theft by calling the IRS’s Identity Protection Specialized Unit (IPSU)
at 1-800-908-4490.
Individuals Granted a Filing Extension by the IRS
If you are required to file a 2015 IRS income tax return and have been granted a filing extension by the IRS, provide a copy of IRS
Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income Tax Return,’’ that was filed with the IRS
for tax year 2015; AND a copy of the IRS's approval of an extension beyond the automatic six-month extension if the individual
requested an additional extension of the filing time for tax year 2015; AND a copy of IRS Form W–2 for each source of employment
income received for tax year 2015. If self-employed, a signed statement certifying the amount of the individual’s Adjusted Gross
Income (AGI) and the U.S. income tax paid for tax year 2015 is required also.
C. Student’s Income Information – Check the box that applies
1.
TAX RETURN FILERS – If you filed or will file a tax return.
 I have used, or will use the IRS Data Retrieval tool to report my income information.
 I will request a 2015 IRS Tax Return Transcript and will submit it at a later date. I understand that verification cannot be
completed until the transcripts are submitted.
2.
TAX RETURN NONFILERS – If you will not file and are not required to file a 2015 tax return. See Non-Filers section above.
 I was not employed and had no income earned from work in 2015. I will submit the Student Non-Filer Statement form.
 I did work in 2015 but I am not required to file a tax return. I will submit the Student Non-Filer Statement form and all W2
Statements or the Wage & Income Transcript directly from the IRS.
D. Parent’s Income Information – Check the box that applies
1.
TAX RETURN FILERS – If your parent(s) filed or will file a tax return.
 The student’s parent(s) used, or will use the IRS Data Retrieval tool to report their income information.
 The student’s parent(s) will request a 2015 IRS Tax Return Transcript and will submit it at a later date. I understand that
verification cannot be completed until the transcripts are submitted.
2.
TAX RETURN NONFILERS – If your parent(s) will not file or are not required to file a 2015 tax return. See Non-Filers section
above.
 The student’s parent(s) was not employed and had no income earned from work in 2015. I will submit the IRS Verification
of Non-Filing letter and the IRS Wage and Income transcript.
 The student’s parent(s) did work in 2015 but is not required to file a tax return. I will submit the IRS Verification of NonFiling letter and the IRS Wage and Income transcript.
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Untax Income
If any item does not apply, enter “N/A” for Not Applicable where a response is requested, or enter 0 in an area where an amount is
requested. Answer each question below as it applies to the student and the student’s parent(s) whose information is on the FAFSA.
To determine the correct annual amount for each item: If you paid or received the same dollar amount every month in 2015,
multiply that amount by the number of months in 2014 you paid or received it. If you did not pay or receive the same amount each
month in 2015, add together the amounts you paid or received each month.
If more space is needed, provide a separate page with the student’s name and ID number at the top.
E. Payments to tax-deferred pension and retirement savings
List any payments (direct or withheld from earnings) to tax-deferred pension and retirement savings plans (e.g., 401(k) or 403(b)
plans), including, but not limited to, amounts reported on W-2 forms in Boxes 12a through 12d with codes D, E, F, G, H, and S.
Name of Person Who Made the Payment
Total Payments to tax-deferred pension
and retirement savings
Annual Amount Paid in 2015
$0
F. Child support received
List the actual amount of any child support received in 2015 for the children in your household. Do not include foster care payments,
adoption payments, or any amount that was court ordered but not actually paid.
Name of Adult Who Received the
Support
Name of Child For Whom
Support Was Received
Total Amount of Child Support Received
Annual Amount of Child Support
Received in 2015
$0
G. Housing, food, and other living allowances paid to members of the military, clergy, and others
Include cash payments and/or the cash value of benefits received. Do not include the value of on-base military housing or the value
of a basic military allowance for housing.
Name of Recipient
Total Amount of Benefits Received
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Annual Amount of Benefits
Received in 2015
Type of Benefit Received
$0
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H. Veterans non-education benefits
List the total amount of veterans non-education benefits received in 2015. Include Disability, Death Pension, Dependency and
Indemnity Compensation (DIC), and/or VA Educational Work-Study allowances. Do not include federal veterans educational
benefits such as: Post-9/11 GI Bill, Montgomery GI Bill, Dependents Education Assistance Program, VEAP Benefits.
Name of Recipient
Type of Veterans Non-Education
Benefit
Total Amount of Veterans Non-Education Received
Annual Amount of Benefits
Received in 2015
$0
I. Other untaxed income
List the amount of other untaxed income not reported and not excluded elsewhere on this form. Include untaxed income such as
workers’ compensation, disability, Black Lung Benefits, untaxed portions of health savings accounts from IRS Form 1040 Line 25,
Railroad Retirement Benefits, etc.
Do not include any items reported or excluded in A – D above. In addition, do not include student aid, Earned Income Credit,
Additional Child Tax Credit, Temporary Assistance to Needy Families (TANF), untaxed Social Security Benefits, Supplemental
Security Income (SSI), Workforce Investment Act (WIA) educational benefits, combat pay, benefits from flexible spending
arrangements (e.g., cafeteria plans), foreign income exclusion, or credit for federal tax on special fuels.
Name of Recipient
Type of Other Untaxed Income
Total Amount of Veterans Non-Education Received
Annual Amount of Other Untaxed
Income Received in 2015
$0
J. Money received or paid on the student’s behalf
List any money received or paid on the student’s behalf (e.g., payment of student’s bills) and not reported elsewhere on this form.
Enter the total amount of cash support the student received in 2015. Include support from a parent whose information was not reported
on the student’s 2016–2017 FAFSA, but do not include support from a parent whose information was reported. For example, if
someone is paying rent, utility bills, etc., for the student or gives cash, gift cards, etc., include the amount of that person's contributions
unless the person is the student’s parent whose information is reported on the student’s 2016–2017 FAFSA. Amounts paid on
the student’s behalf also include any distributions to the student from a 529 plan owned by someone other than the student or the
student’s parents, such as grandparents, aunts, and uncles of the student.
Purpose: e.g., Cash, Rent, Books
Total Amount Received
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Annual Amount Received in
2015
Source
$ 0
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K. Housing Situation – Check the box that applies
My household lives:
In pubic housing
With other family members
Military Base
With a room mate
L. Additional information
Please provide information about any other resources, benefits, and other amounts received by the student and any members of the
student’s household. This may include items that were not required to be reported on the FAFSA or other forms submitted to the
financial aid office, and include such things as federal veterans’ education benefits, military housing, SNAP, TANF, etc. If more
space is needed, provide a separate page with the student’s name and ID number at the top.
Name of Recipient
Annual Amount of Financial
Support Received in 2015
Type of Financial Support
Total Amount Financial Support Received
$0
M. Comments
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
N. Sign this Worksheet
Each person signing this form certifies that all the information reported on it is complete and correct. If a correction is needed, you
authorize Savannah State University to make the correction. The student and a parent must sign and date.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or
both.
Student’s Signature
Date
Parent Signature
Date
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