Ivy Tech Community College of Indiana DEPENDENT CHILD ACKNOWLEDGEMENT FORM FOR PURPOSES OF FEE REMISSION

One of the following three conditions must be met to qualify an individual as a dependent child for purposes of fee remission. For purposes of this provision, a dependent child is the employee's child, stepchild, foster child, who lives in the employee's home for the entire year, a legally adopted child, or a child placed in the employee's home by a placement agency.

1.  The dependent child currently resides in the employee's household and currently earns less than $2,450 in gross income for the tax year. This requirement does not have to be met if the dependent child is:
(1) under age 19 at the end of the calendar year; or
(2) a full-time student under age 24 at the end of the calendar year and in school for at least five months during the year.

1. The dependent child currently resides in the employee's household and currently earns less than $2,450 in gross income for the tax year. This requirement does not have to be met if the dependent child is: (check qualifier) (1) under age 19 at the end of the calendar year; or (2) a full-time student under age 24 at the end of the calendar year and in school for at least five months during the year.
2. The dependent child receives over half of his or her support from the employee and the dependent child is claimed as a tax exemption. Support includes expenditures for such items as food, lodging, clothes, medical and dental care, and education. Support is calculated as the actual cost of the above items. Money received by the dependent from nontaxable sources, e.g. social security must be used in calculating support. Student scholarships are excluded from the support test.
3. The employee is a divorced, non-custodial parent who claims the child as a dependent/tax exemption because: (check qualifier) (1) the custodial parent agrees on IRS Form 8332 not to claim the dependent child for tax purposes for the calendar year; or (2) a divorce decree executed prior to 1985 states that the employee is entitled to claim the dependent as a tax exemption, and the employee provided at least $600 in child support during the calendar year.
By signing this form the employee acknowledges that the dependent child meets one of the above conditions for purposes of fee remission.
Employee Signature                                                                           Date
Dependent Name                                                                               Social Security Number

Check One
Term	Fall	Spring	Summer

 

Return this form with the Waiver of Fees form to the Human Resources Office.