Independent Student Tax Return Filing Status Review for 2022-2023

Student Name*

First

Last

Student ID*

A review of your 2023-2024 Free Application for Federal Student Aid (FAFSA) indicates that there is conflicting information between your tax return filing status and marital status. We will need additional information before we can determine your eligibility for financial aid. If the conflict requires further resolution, you may need to submit your (and/or your spouse's) 2021 Federal Tax Return Transcript or a signed copy of your (and/or your spouse's) 2021 Federal Tax Return with Schedules 1, 2 and/or 3 and W-2s. Please provide the following information:

What is your (the student's) Marital Status as of the date you completed the 2023-2024 FAFSA*

If Married / Re-Married, provide Date of Marriage

If Divorced, provide Date of Divorce

If Separated, provide Date of Separation

If Widowed, provide Date Widowed

Please indicate your (the student's) and spouse's (if married) tax filing status as stated on your 2021 Federal Tax Return

STUDENT - For the 2021 tax year, what was your tax return filing status?*

Single
Head of Household (HOH)
Married Filing Joint (MFJ)
Married Filing Separately (MFS)
Qualifying Widower
Did not file

SPOUSE - For the 2021 tax year, what was your spouse's tax return filing status?*

Single
Head of Household (HOH)
Married Filing Joint (MFJ)
Married Filing Separately (MFS)
Qualifying Widower
Did not file

Student's 2021 Earnings Information

Please answer the following questions whether or not a tax return was filed by you or your spouse (even if you were not married in 2021). This information may be on the W-2 forms, on IRS Form 1040 Schedule 1, Lines 3 + 6 + Schedule K-1 (IRS Form 1065) Box 14 (Code A). If any individual earning item is negative, do not include that in your calculation.

NOTE: If you and/or your spouse had no income from work in 2021 enter zero “0”.

How much did you, the student, earn from working in 2021?*

How much did your spouse (if married) earn from working in 2021?

I understand that once this form is received and reviewed, additional information may be required. I certify that all of the information reported above is true and correct. I understand that purposely giving false or misleading information could result in a fine, imprisonment or both as it relates to my reporting information to the U.S. Department of Education.

Student's Signature*

Spouse's Signature