Please complete the required information below. If you have questions while completing the form, please visit https://studentcentral.indiana.edu/ for additional help from our virtual assistant or call (812) 855-6500 during business hours.
Please list your employer, income amount earned, and attached the 2019 W-2 form that you received from your employer. List additional employers in the spaces below. If you were self-employed and did not receive a W-2 form, please indicate 'self-employed' and the type of work performed in the employer section.
Employers are required to provide W-2 forms to their employees. 2019 W-2 forms are typically issued in January 2020. If you did not receive a W-2 form, you may request one from your employer or request a Wage and Income Transcript from the IRS here, https://www.irs.gov/individuals/get-transcript.
If the income you entered above is different than the amount you entered on your FAFSA, please use this space to clarify why there is a discrepancy between the amounts entered on this form and your FAFSA. You may also use this space if you have more than three employers to list above.
For example, SSI, SNAP, TANF, WIC, disability, unemployment, worker's comp, family support.
Please enter the amount received in 2019. For benefits that were not received, please enter $0.
Enter amount received in 2019
If you received other income or support (disability, unemployment, worker's comp, family support, etc) please describe the type of support and the annual amount here.
In addition to this form, you must submit the 2019 IRS Verification of Nonfiling Letter which may be ordered for free on the IRS site, https://www.irs.gov/individuals/get-transcript, or by faxing or mailing the IRS Form 4506-T to the IRS.
You have indicated that you worked and filed taxes in 2019. Please do not submit this form. Instead, complete the IRS upload via the FAFSA: https://studentaid.gov/resources/irs-drt-text
Signature certifies that you have read the statement below. Form must be signed by hand after submitted and dated. An incomplete form will delay or prevent processing. Please allow 10-15 business days for processing.
I certify that all of the information provided on this form is correct to the best of my knowledge. I understand that if I purposely give false or misleading information on this form I am liable for cancellation or repayment of all or part of my financial aid. In addition, I understand that completing this form does not guarantee an increase or adjustment in financial aid.
After form is submitted, the space below will be used for the parent to sign by hand before submitting the completed form to the Office of Student Financial Assistance.
Please provide parent signature here:
After clicking Submit, you will receive a confirmation email that includes all the information inputted on the form. Please print the confirmation email then have the parent sign the form. Once signed, submit the completed form via the Student Central Secure Contact Form at http://go.iu.edu/zsZ.