"Statement of Non-Filing"
PITZER COLLEGE Financial Aid Office STATEMENT OF NON-FILING Student’s Name (Please Print) Social Security Number The information below pertains to (check only one): Student Student and Spouse Parent(s) of Student I (we) have not filed and will not file a 2008 U.S. Income Tax return 1040EZ/1040A/1040. All sources of income received during 2008 are listed below. I have attached all W-2 forms for income listed. Total amount of income received in 2008: $ PLEASE LIST BOTH SOURCE AND AMOUNT OF ALL INCOME RECEIVED Source Amount Received Student Signature Parent or Spouse Signature Name (Please Print) Name (Please Print) Date Date Return this form to: Financial Aid Office Pitzer College 1050 N. Mills Avenue Claremont, CA 91711-6101 1/2009