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Statement of Income and Expenses

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Form number: 2064

This form can be used for all award years.

You need to fill out this form if you applied for the Deferred Payment Plan and are declaring self-employment income.

Download the form

Digital transmission

Print the form, fill it out, then sign and scan it. Use your online file to upload your document.


Other way to submit your document


If you are unable to submit this form digitally you can mail it to us. Print the form, fill it out, sign and mail it to the address shown on the form itself.