Texarkana College-EOC-Income Verification Form

The Educational Opportunity Center at Texarkana College is a federally funded TRIO program and all services are provided to program participants FREE OF CHARGE. All individuals who meet the eligibility requirements of this program are provided information regarding financial and academic assistance necessary for them to enter the college of their choice. This is an outreach program of the U.S. Department of Education and Texarkana College.

Participant (Students) Legal Name: *

First NameMILast Name

* All Information below should be based solely on the parent (s) of the participant named above:

Parent’s Legal Name: *

First NameMILast Name

Parent’s Email Address:*

example@example.com

What is your current marital status?*

Are there any children under the age of 18 in your household?*

YesNo

Including yourself, how many people are supported by your income?*

Did you or will you file a 2024 Tax Return?*

YesNo

If yes, what was your (and your spouses) taxable income?*

(this can be found on IRS 1040 line 15 of your tax return)

If no, how much did you (and your spouse) earn in wages/salary in the previous year?*

Do you or the student’s other natural or adoptive parent(s) have a four-year (bachelor’s) college degree?*

YesNo

I declare that the information on this form is true to the best of my knowledge. The Educational Opportunity Center at Texarkana College is authorized to access information deemed necessary to assist in meeting the reporting requirements of the U.S. Department of Education, to record pertinent facts regarding my eligibility in the Program, services rendered, and placement. A copy of this statement shall serve as such authorization.

Signature of Parent:*

Date*

mm-dd-yyyy

Educational Opportunity Center at Texarkana College

PARENT INCOME VERIFICATION FORM

Household Size

Financial Information

Family Educational Background

Authorization