Harvard College Griffin Financial Aid Office

(p) 617.495.1581
Verification of Non-Filer Status
2021-2022

Student Information

Student Name: Class of:

If you or your parent(s) did not and were not required to file a 2019 income or
national tax return, please complete the following information and submit this
form, along with any wage statements.
Each non-filer must complete a separate statement.

I, _______________________________________, verify that I did not and was not required to file a
National Income Tax Return for the year 2019. The amounts and sources of my income are listed below.
All information on the financial aid application materials that will be used to calculate my (child’s) aid
eligibility is complete and correct.

Wages (please attach wage statement or letter

$
from your employer)
Business Income $
Pension Income $
Child Support Received $
Rental Income $
Other (explain) $
$
TOTAL $

By signing, I certify that all the information reported is complete and correct.

Signature (of non-filer) Date

Relationship to student