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Tulsa Community College
 Income Verification Form
TRIO Student Support Services
909 S Boston Ave
Tulsa , OK 74119
tulsacc.edu/trio
TRIOSSS@tulsacc.edu
918-595-8970
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Please complete the Income Verification which is used to determine your program eligibility.
Verification requirements vary depending on whether you are an INDEPENDENT or DEPENDENT student, according to federal criteria which is available on the FAFSA website www.fafsa.gov
Per your TRIO SSS application and your determined dependency status be sure to provide information from the most recent tax year:
If you are an Independent Student (typically age 24+, married, emancipated minor, veteran, or parent providing over half of child(ren)’s support) complete Part A and then provide your signature.
If you are a Dependent Student (typically younger than 24, unmarried); parent/guardian information is reported on FAFSA. Your parent/guardian must complete Part B and then provide their signature.
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 Part A - Independent Students  (Dependent Students skip to Part B)
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My most recent tax year is:
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I did not file a tax return in the tax year designated above because I was not required to file.
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Part B - Dependent Students (Parent/guardian information)
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My most recent tax year is:
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I/We did not file a tax return in the tax year designated above because I was not required to file.
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Sign and Submit:
By signing, I declare under penalty of perjury that the income verification information I have provided is true and correct to the best of my knowledge.
Independent Students complete with your own signature.
Dependent Students complete with a parent/guardian signature.
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Please Indicate Who is Signing the Form
*
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Click here to start signing.
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