Parent(s) 2022 Income Tax Return Filing Status Verification

Your student’s financial aid application was selected for a process called verification by the U.S. Department of Education. Either you, your spouse or partner, or both of you indicated on your student’s financial aid application that one or both of you did not and will not file a 2022 Income Tax Return.

The form below must be completed for each of the student’s FAFSA contributors that did not and will not file an income tax return in 2022. The form must be submitted to the Financial Aid Office before we can continue the review process and determine your student’s eligibility for federal financial aid.

Student Information

Student’s Name (Last, First, M.I.)	Student ID - REQUIRED

B. Parent(s) 2022 Income Tax Return Filing Status

Select ONE option from the four provided below if you are a contributor to your student’s financial aid application. If you are unmarried and do not live with the student’s other parent, provide information only about yourself. If you are married, remarried, or unmarried and living with the student’s other parent, you must enter information for whichever of you did not and will not file a tax return, or for both of you if neither of you did or will file a tax return.

Parent Name:
(First, Middle Initial, Last)

☐ I earned income in 2022 but did not file, nor was I required to file, an income tax return. I have listed my sources and amounts of earnings, other income, and resources that helped to support my family in the box below. If additional space was needed, I have attached an additional sheet with the required information. My student’s name and student ID has been placed at the top of the additional sheet.

☐I have been granted a 2022 income tax filing extension beyond the automatic six-month extension. As required:

I have attached a copy of the IRS’s approval of an extension beyond the automatic six-month extension;

I have listed my sources and amounts of earnings, other income, and resources that helped to support my family in the box below; and

If I am self-employed, I have attached a signed statement estimating my 2022 AGI and taxes paid.

If additional space was needed, I have attached an additional sheet with the required information. My student’s name and student ID have been placed at the top of the additional sheet.

☐ I was not employed in 2022 and earned no income from work. I have listed my sources and amounts of unearned income and resources that helped to support my family in the box below.

Source of Earnings, Other Income, and Resources	Amount Received in 2022
Example: Dan’s Autobody	$2500.00

☐ I earned income and filed a 2022 tax return.

Student Name: Student ID:

Spouse/Partner Parent Name:
(First, Middle Initial, Last)

Select ONE option from the four provided below.

☐ I earned income in 2022 but did not file, nor was I required to file, an income tax return. I have listed my sources and amounts of earnings, other income, and resources that helped to support my family in the box below. If additional space was needed, I have attached an additional sheet with the required information. My student’s name and student ID has been placed at the top of the additional sheet.

☐ I have been granted a 2022 income tax filing extension beyond the automatic six-month extension. As required:

I have attached a copy of the IRS’s approval of an extension beyond the automatic six-month extension;

I have listed my sources and amounts of earnings, other income, and resources in the box below; and

If I am self-employed, I have attached a signed statement estimating my 2022 AGI and taxes paid.

If additional space was needed, I have attached an additional sheet with the required information. My student’s name and student ID has been placed at the top of the additional sheet.

☐ I was not employed in 2022 and earned no income from work. I have listed my sources and amounts of unearned income and resources that helped to support my family in the box below.

Source of Earnings, Other Income, and Resources	Amount Received in 2022
Example: Dan’s Autobody	$2500.00

☐ I earned income and filed a 2022 tax return.

C. Certification and Signatures

Each person signing below certifies that all the information reported on this worksheet is complete, correct, and any additional information is attached. The student and each parent non-filer MUST sign and date this section. NOTE: All signatures must be hand-signed or electronically signed, such as with a digital stamp or a stylus, finger, or touchpad.

WARNING: If you purposely give false or misleading information on this worksheet you may be fined, sentenced to jail, or both.

Click or tap to enter a date.
Student Signature	Date
Click or tap to enter a date.
Parent Signature	Date
Click or tap to enter a date.
Parent Spouse/Partner’s Signature	Date

You can log into MyVPCC and upload this form in the To Do list or by logging into the http://mysupport.vpcc.edu/ using your MyVPCC login information, fax to (757)825-3537, or bring in person (Hampton Campus, Griffin Hall, room 209/Historic Triangle campus, room 117A).