Documentation of Income Guidelines

If You or Your Family Have or Receive:

Then Please Submit:

Income from wages, dividend interest, rental, business profits

Signed copy of 2012 Parent’s Federal Income Tax Form (1040, 1040A, 1040EZ)
with Schedules A and C attached.

Social Security, Public Assistance, Veteran's Benefits, SSI

A completed and signed/stamped
Benefit Verification Form

No Income

IRS letter 1722. Call IRS at 800-829-1040
to request the letter. Use Form 4506-T to request.

Pension or Annuity

Letter from agency stating 2012 total award