INCOME VERIFICATION

As parent or guardian of:
Social Security Number *
First Name
Last Name
Date of Birth *
Which high school do/did your student attend?
How many people are in your family??
What is the Adjusted Gross Income Range of your Family (Most Recent Tax Return line 11)?
What is your Family's Taxable Income Range (Most Recent Tax Return line 15)
Which high school do/did you attend?,
Which Standard Deduction Did you Parents Use when filing their Tax Return (Most Recent 1040 Line 12)?
By providing my signature electronically, I am certifying that I give permission for my student to participate in the EOC Trio Program and that the income information presented above is accurate to the best of my knowledge:
Parent or Guardian Signature *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.