Verification of Economic Sufficiency
Frank Phillips College
Financial Aid Office
Student Name: _____________________________ Social Security Number: ____________________
Information requested is for school year 2020-2021 and is regarding:
__________ Student and/or __________ Parent
All persons that are checked above must complete the sections below and sign the back of this form.
Section A
According to your Students Aid Report (SAR): your family of _____ lived off of
$__________ income for the year of 2018.
Please explain how you were able to do this: (Medicaid, HUD, TANF, SNAP, family etc.)
Section B
In the grid below: please list totals received for the year of 2018.
Child support received for all children. (No foster/adoption payments.)
Welfare benefits, including TANF. Do not include Food Stamps.
Social Security Payments that were not taxed.
Cash or money paid on your behalf, not reported elsewhere on this form.
Housing, food and other living allowances paid to members of the military.
Veteran’s non-education benefits, such as Death Pension or DIC.
Section C
Please answer the following questions regarding YOUR income for the school year of
Do you receive and will continue to receive (to the best of your knowledge) any of the
HUD [ ] YES [ ] NO
Housing Assistance [ ] YES [ ] NO
Medicaid [ ] YES [ ] NO
WIC [ ] YES [ ] NO
TANF [ ] YES [ ] NO If yes, monthly amount=$_________
Food Stamps [ ] YES [ ] NO If yes, monthly amount=$_________
Child Support [ ] YES [ ] NO If yes, monthly amount=$_________
Are you currently employed? [ ] YES [ ] NO If yes, monthly amount=$_________
Will you continue your employment while attending school:
[ ] YES [ ] NO
Certification: I certify that all of the information provided on this form is true to
the best of my knowledge.
_____________________________ _____________________________
Student Signature Date Parent Signature Date
Frank Phillips College is an equal opportunity education institution and employer. Its students and
employees are selected and/or assigned without regard to age, race, color, creed, sex, national
origin, or disability, consistent with Titles VI and VII of the Civil Rights Act of 1964, and Title IX of the
Higher Education Act amended in 1972, and Section 504 of the Rehabilitation Act of 1973. The
ce coordinator for Title IX is Dr. Shannon Carroll (; 806-457-4200, ext. 732)
and Section 504 is Becky Green (; 806-457-4200, ext. 777).
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