Seminole State College-SSS-Income Verification Form

PARENT INCOME VERIFICATION
Student Name:*

First NameLast Name
Email*
example@example.com
Student ID:*
2022 TAXABLE Income:*
(line 15 of 2021 1040 Return)
Size of family unit:*
I confirm, to the best of my knowledge, that the above listed information for my 2020 Annual Taxable Income is accurate.
Parent Signature**

Clear
*dependent students must have parent signature
Date*

MonthDayYear
mm-dd-yyyy

PARENT INCOME VERIFICATION