TRIO Student Support Services Program
Income & Educational Attainment Verification Form - INDEPENDENT Student To be Completed by the Student
Student's Name:
*
First Name
Last Name
Student's KC ID #
*
Phone Number
-
Area Code
Phone Number
Did either of your parents/legal guardian earn a 4-year degree from a college/university?
*
Please Select
Yes
No
Number of people living in your household
*
Did you file taxes this year?
*
Please Select
Yes
No
What was your 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. Signature:
*
Submit
Should be Empty: