TRIO SSS Income Certification

Last Name:*

First and Last Name

First Name:*

First and Last Name

TRI-C ID:*

Example: S012345678

Preferred Email:*

MyEmail@example.com

Preferred Phone Number:*

Enter a valid phone numberFormat: (000) 000-0000.

Today's Date:

Date

The TRIO Student Support Services program is funded by the U.S. Department of Education, which requires disclosure of applicants' household income. Complete the information below to indicate your 2024 income. If you are a dependent student, then indicate your and your parent(s)'/guardian(s)' combined 2024 income.

During 2024, how many people lived in the household?*

What is your 2024 total household income?*

Federal TRIO Programs: Income guidelines effective 1/13/2026
Size of Family Unit 48 Contiguous States, D.C., and Outlying Jurisdictions Alaska Hawaii

Family Members	US States	Alaska	Hawaii
1	$23,940	$29,925	$27,540
2	$32,460	$40,575	$37,335
3	$40,980	$51,225	$47,130
4	$49,500	$61,875	$56,925
5	$58,020	$72,525	$66,720
6	$66,540	$83,175	$76,515
7	$75,060	$93,825	$86,310
8	$83,580	$104,475	$96,105

For family units with more than eight members, add the following amount for each additional family member: $8,520 for the 48 contiguous states, the District of Columbia and outlying jurisdictions; $10,650 for Alaska; and $9,795 for Hawaii.The term "low-income individual" means an individual whose family's taxable income for the preceding year did not exceed 150 percent of the poverty level amount.The figures shown under family income represent amounts equal to 150 percent of the family income levels established by the Census Bureau for determining poverty status. The poverty guidelines were published by the U.S. Department of Health and Human Services in the Federal Register on January 15, 2026 and are effective as of January 13, 2026.

By signing below, you certify that the income information and all other information provided is current, true and accurate to the best of your knowledge and belief.

Signature:*

Student Support Services Program