Income Verification Form

Thank you for your interest in the Student Support Services Classic program. Please complete this Income Verification Form as thoroughly as possible.  You cannot save and restart this form.  You may want to review the included items, take some time to make notes and gather the required documents, and then return to submit the form. If you have any questions, please contact us at at (352) 395-5836, or

Visit our website to learn more. 

Student Last Name *
Student First Name *
Student Middle Name
I am a(n): *
My family filed a 2021 tax return, and the total number of people in our family, including the student, was: *
My family filed a 2021 tax return, and the taxable income reported was: *

It is important to report Taxable Income not Adjusted Gross Income.  Your taxable income can be found on 2020 tax form 1040, line15.  

If you did NOT have a taxable income in 2021 tax return, please enter 0. 


To determine your family size, include:

  • -Yourself (and if married, your spouse)
  • -The number of children who will receive more than half of their support from you (even if they don’t live with you, and if married, your spouse's)
  • -The number of people who live with you and receive more than half of their support from you, and will continue to receive more than half of their support from you.

Why do we ask for income verification documents?

As a federally funded TRiO program, Student Support Services at Santa Fe College is required to provide student eligibility documentation to the U.S. Department of Education, and as stated in the Higher Education Act of 1965, at least two thirds of the students served must meet federal low-income guidelinesStudents must provide family income documentation to be considered as a candidate for the programDependent students must have their parent’s or legal guardian’s signature on the Income Verification Form

 The information is protected by the Family Rights and Privacy Act and will be held in strict confidence.

Documents considered for income verification purposes include:  

    • Signed Income Verification Form OR 
    • FAFSA submitted to the college OR 
    • Copy of Signed United States or Puerto Rico tax return OR
    • Verification from another governmental source 


Sign and Submit

Terms of Submission:

By submitting this application, you acknowledge that all of the above information is correct and accurate to the best of your understanding.

Parent or Independent Student First and Last Name: *
Cell Phone Number: *
Date: *
Signature: *
Signature Type: Simple    Start Over
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Signature: (Type in your full name)
I agree to the terms included.
Santa Fe College Student Support Services Classic (SSS), and the printing of document, are made available through a 100% federally funded Department of Education grant totaling $335,111.00 per year.