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TRIO Rising Scholars Income Verification Form

As a federally funded grant program, we (TRIO) are required to verify the income status of every student who applies and enrolls in our program. Please read carefully through the following instructions before filling out and submitting this form:

  1. If your parent/s or guardian/s claimed you as a dependent on their taxes, then you will need to work with them and use their most recent tax transcripts to complete this form. They would also be electronically signing this document. If you, the student, were not claimed as a dependent and are financially independent, then complete this form using your most recent tax transcripts and in this case, you would be electronically signing this document. Please note: The only circumstances where a student would be completing this form and certifying/signing would be if you are considered financially independent as a student. Financially independent would be someone who is at least 24 years old as of January 2019, is married, is a veteran of the US Armed Forces, an emancipated minor, and/or is or was an orphan or a ward of the court until age 18.
  2. Collect copies of the most recent 1040 series tax transcripts for the appropriate person/s as defined in the previous paragraph. If you need assistance obtaining copies of tax transcripts, you can follow the instructions on the IRS website here.
  3. Identify family size. Family size is defined as the total number of family members identified on whichever tax transcript you are using. For example, if you have parents who are married and filed jointly, have claimed you and two siblings as dependents, then you would have a total family size of five people. If you are financially independent, as defined above, family size is defined as the total number of family members on your tax return transcript.
  4. To identify your family’s taxable income, refer to line 27 of the 1040a; line 6 of the 1040EZ; or line 43 of the 1040 for whichever tax return applies to your family.


  • Student Name * Required
  • As the appropriate person completing this form as outlined in the instructions, I certify that this information is true and accurate to the best of my knowledge. I understand that this information is only used to determine the type of eligibility status and for reporting purposes. REMINDER: The only case in which the student would be certifying and signing this statement would be if they are financially independent and are no longer claimed as a dependent for tax purposes. * Required
  • Date Format: MM slash DD slash YYYY