morehouse school of medicine
Office of Student Fiscal Affairs
(Include spouse, if applicable)

Note:  Whether you filed a tax return or not, you must submit copies of all W-2 and/or 1099 forms received for the 2013 tax year.

Student and spouse (if married) who will not file a 2013 Federal Income Tax Return must complete this form.

Please complete ALL sections of the form.  Enter “0” if you did not receive any taxable and/or nontaxable income.

Contact Information

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Academic Program (Please check one): *

Federal Tax Information

I (we) did not and will not file a 2013 Federal Income Tax Return, IRS Form 1040, 1040A, or 1040EZ for the following reasons (check one):