TRIO Student Support Services Program
Income & Educational Attainment Verification Form - DEPENDENT Student (under age 24, unmarried, not financially responsible for children)
Student's Name:
*
First Name
Last Name
Student's KC ID #
Name of Parent/Legal Guardian
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Number of people living in your household
*
Did either of your parents/legal guardian earn a 4-year degree from a college/university?
*
Please Select
Yes
No
Did the parent/legal guardian file taxes this year?
*
Please Select
Yes
No
What was your parent/legal guardian's most recent TAXABLE income (line 15 on Form 1040)?
*
This is NOT adjusted gross income.
All of the information on this form is true and complete to the best of my knowledge. Parent/Legal Guardian Signature:
Submit
Should be Empty: