Parent/Guardian of Dependent Student OR Independent Student: The federal government requires that we have income documentation on file for all of our students. For your or your student's application to be complete, we need the following information.

(An independent student must meet at least one of the following: 24 years old, married, serving active duty in military, foster care or ward of the state, etc. Discuss with SSS staff if you have any questions re: status)  
Student First Name *
Student Last Name *
Parent Name (if student is dependent)

The table below shows the low income amounts based on family size and federal taxable income.
Your federal taxable income can be found on line 15 of the IRS tax form 1040. Please note, this is different than your adjusted gross income.

Please review your family size and income level and report in the following question if it was at or below the amount listed for family OR above the amount listed for size of family.

Size of Family Unit

48 Contiguous States, D.C., and Outlying Jurisdictions

Alaska

Hawaii

1

$22,590

$28,215

$25,965

2

$30,660

$38,310

$35,250

3

$38,730

$48,405

$44,535

4

$46,800

$58,500

$53,820

5

$54,870

$68,595

$63,105

6

$62,940

$78,690

$72,390

7

$71,010

$88,785

$81,675

8

$79,080

$98,880

$90,960

Size of Family Unit *

Please Check One:
Our taxable family income was at or below the amount listed for size of family.
Our taxable family income was above the amount listed for size of family

I verify the above information is accurate.  The below signature is either the parent signature of a dependent student, OR an independent student signature.  

 
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