Aarp Foundation Web Based Scsep Application Form (Page 5 of 7) in pdf

Aarp Foundation Web Based Scsep Application Form Page 5

ARRP FOUNDATION

Web Based SCSEP Application Form

SUPPORTING DOCUMENTATION SUMMARY

***IMPORTANT: Because this is a federally funded program through the U.S. Department of

Labor, supporting documentation must be included with your application in order to verify the

information that you entered into the application.

For each income that you listed on the previous pages that requires documentation, please choose

from the approved forms of documentation list below and include photocopies of those documents

when submitting your application.

Age:

Driver's License

Birth Certificates

Social Security Administration

statements

Family Bible

Passports

Residence: Documentation containing the name and address of the applicant

Driver's License

Property Tax Notice

Utilities Bills

Rent Receipts

Income:

W-2(s)

Check stubs from employer showing year-to-date

Social Security Administration

earnings

statements

Form 1099

Verification of current gross Social Security checks and/or pension checks

IRS 1040

Bank statements showing deposits

form

NOTE: Bank statements cannot be used to document Social Security income

NOTE: Documentation must show GROSS income (..not Net income) or method of achieving gross

income figures.

NOTE: If you are not claiming any family income and your income is $0.00, please complete the

Certification of No Income form on page 7.

Family Size:

Housing Lease indicating number of occupants

Food Stamps documentation indicating number in family

Tax Return indicating number in family

Or… complete the form on page 6 and submit it with your application

Revised: 9/21/2011

Aarp Foundation Web Based Scsep Application Form Page 5