Spouse Non-Filer Form - Certification of Income

2012-2013 Financial Aid Filing Status of Spouse

This form must contain information about the spouse's financial resources for 2011

Student Information

Financial Aid Information
  1. THIS IS TO CERTIFY THAT I/WE DID NOT AND/OR WILL NOT FILE A FEDERAL INCOME TAX RETURN FOR 2010 AND THAT ALL OF THE INFORMATION ON MY APPLICATION FOR FEDERAL STUDENT AID IS TRUE AND CORRECT.
  2. THIS IS TO ALSO CERTIFY THAT MY/OUR 2011 INCOME CONSISTED OF THE FOLLOWING:
    1. $
    2. NON-TAXABLE INCOME
      1. $
      2. $
      3. $
      4. $
      5. $
      6. $
      7. $
      8. $
      9. $
      10. $
      11. $
      12. $

If any blank is unanswered this form will be rejected which will delay your Financial Aid.

I certify that the information on this form is true and correct by signing with either an original or electronic signature.

Spouse's Signature: ________________________________________ :

Complete, print, and return completed form to:

Office of Financial Aid
Box 93260 MSU
Lake Charles, LA 70609
Phone: (337) 475-5065
Fax: (337) 475-5068
E-mail: finaiddocs@mcneese.edu