PER
M57B-l (AC)
Name: Date:
Thank you for your submission of the SEED Scholarship application. As one of the criteria for the grant money we received
providing for these scholarships, we must report on the number of individuals who received scholarships in the low to
moderate income levels. We ask for your assistance in completing this additional chart and returning it as soon as possible.
All information will be kept confidential. This is solely for reporting purposes back to our grantor.
HOUSEHOLD AND INCOME VERIFICATION
Please select the number of people in your household
under the Household Size column and the appropriate gross income
category from one of the (5) five columns immediately to the right of the Household Size number.
Household Size
1 person $0 – $15,675 $15,676 – $26,125 $26,126 – $41,800 $41,801 -- $50,160 > $50,161
2 people $0 – $17,925 $17,601 – $29,875 $29,876 – $47,800 $47,801 -- $57,360 > $57,361
3 people $0 – $20,156 $20,157 – $33,594 $33,595 – $53,750 $53,751 -- $64,500 > $64,501
4 people $0 – $22,388 $22,389 – $37,313 $37,314 – $59,700 $59,701 -- $71,640 > $71,641
5 people $0 – $24,188 $24,189 – $40,313 $40,314 – $64,500 $64,501 -- $77,400 > $77,401
6 people $0 – $25,988 $25,989 – $43,313 $43,314 – $69,300 $69,301 -- $83,160 > $83,161
7 people $0 – $27,769 $27,770 – $46,281 $46,282 – $74,050 $74,051 -- $88,860 > $88,861
(Draft Income Information. Calculations are based on 2018 80% LMI data for Lehigh County.)
