Northwestern State University 212 Student Services Center Natchitoches, Louisiana 71497 Office of Student Financial Aid Telephone (318) 357-5961 Fax (318) 357-5488 2014-2015 Non-Filer Worksheet Complete the below information if you, the parent (and, if married, your spouse), will not file and are not required to file a 2013 income tax return with the IRS. ______________________________________________________ Student’s Name ___________________/ _____________________ Last 5 digits of SSN NSU Student ID # A. Student/Spouse Information Please check the one that applies and complete the appropriate information: _____ Student (and spouse, if married) was not employed and had no income earned from work in 2013. Therefore, was not required to file a 2013 tax return. _____ Student (and spouse, if married) were employed in 2013 and have listed in the wage box below the names of all employers and the amount earned from each employer in 2013, but was not required to file a 2013 tax return. (Please provide copies of all 2013 W2 Forms) Employer’s Name Income Earned From Income Earned From Work for Student Work for Spouse Suzy’s Auto Body Shop (example) $2000 B. Parent(s) Information (for Dependent Students Only) Please check the one that applies and complete the appropriate information: _____ Parent (and if married, parent’s spouse) was not employed and had no income earned from work in 2013. Therefore, was not required to file a 2013 tax return. _____ Parent (and if married, parent’s spouse) were employed in 2013 and have listed in the wage box below the names of all employers and the amount earned from each employer in 2013, but was not required to file a 2013 tax return. (Please provide all copies of 2013 W2 Forms) Employer’s Name Income Earned From Income Earned From Work for Mother Work for Father Suzy’s Auto Body Shop (example) $2000 C. CERTIFICATION AND SIGNATURE Each person signing below certifies that all of the information reported is complete and correct. The student whose information was reported on the FAFSA must sign and date. Warning: If you purposely give false or misleading information, you may be fined, be sentenced to jail, or both. ______________________________________________________________________________ Student’s Signature Date Parent’s Signature Date (Required for Dependent students)