GROSS I NCOME I S DEFI NED AS FOLLOWS: Any monies BEFORE ANY DEDUCTI ONS such as income taxes,

social security taxes, insurance premiums, charitable contributions, and bonds.

Grossincome includesthe following: (1) monetary compensation for servicesincluding wages, salary, commissions, or fees; (2) social
security; (3) public assistance or welfare payments; (4) unemployment compensation; (5) alimony or child support payments; (6) government
civilian employee or military retirement or pensionsor veteran payments; (7) net rental income; (8) dividendsor interest on savingsor bonds
or income from estatesor trusts; (9) regular contributionsfrom personsnot living in the household, and (10) other cash income.
OAK PARK AND RI VER FOREST HI GH SCHOOL
Instructions to Apply for the 2013-14 OPRF IMF/District Fee Waiver

!"#$%&'% LlsL all arenL(s)/Cuardlan(s) and legal dependenLs llvlng ln Lhe household. lnclude ln and name of school
aLLendlng. (#)*+*,-"*./%01!"%2#%*/,314#45 ALLach copy(s) of compleLed 2012 lorm 1040 u.S. lndlvldual lncome 1ax 8eLurn, C8
boLh sldes of currenL !""#$%&' or oLher lnsurance card llsLlng all famlly members, C8 a slgned and noLarlzed affldavlL aLLesLlng Lo Lhe
famlly members llvlng ln Lhe household. /()*+#,-.-#/)#01#
2)34561*16#175850719#/&4#:36#532)+1#+;4/#01#<*1413/16#/)#61/1*+531#175850575/=9

!"#$%6' LlsL ALL C8CSS lncome >411#61?535/5)3@ of LvL8? person ln household under approprlaLe column.
(#)*+*,-"*./%01!"%2#%*/,314#45 ALLach coples of one or more Lype(s) of AccepLable uocumenLaLlon Lo verlfy reporLed lnformaLlon.

-7789:;<=8%4>7?@8A:;:B>A%:>%-::;7C:
DMuS1 lnCLuuL 2012 u.S. lederal lncome 1ax 8eLurn wlLh ALL 1Ax SCPLuuLLS
Anu CnL Cl 1PL lCLLCWlnC uCCuMLn1S
#;EABAFGHI;F8GH!;=;EJ%K>E%8;7C%L><5%
LasL 2 currenL paycheck sLubs LhaL show how ofLen lL ls recelved,
LeLLer from employer sLaLlng gross wages and how ofLen Lhey are pald, or
8uslness papers, such as ledger or Lax books lf self-employed.
ht%
noLlce of ellglblllLy from SLaLe LmploymenL SecurlLy Cfflce,
Check sLub of compensaLlon, or
LeLLer t.
!>7B;=%!87?EB:JH$8AGB>AGH)8:BE8@8A:H(-%28A8KB:GH!:EBM8%28A8KB:G5%
Soclal SecurlLy reLlremenL beneflL leLLer,
SLaLemenL of SupplemenL SecurlLy beneflLs (SSl) recelved for each person,
enslon award leLLer, or
veLerans Affalrs beneflL leLLer/unlon SLrlke beneflL leLLer.
,CB=N%!?99>E:H-=B@>AJ5%
CourL decree, agreemenL, or coples of checks recelved.
-==%>:C8E%BA7>@85%
lnclude regular conLrlbuLlons from people who do noL llve ln your household, or
lf you have oLher forms of lncome (such as renLal lncome) send lnformaLlon or papers LhaL show Lhe amounL of
lncome recelved, how ofLen lL ls recelved, and Lhe daLe recelved.
/>%BA7>@85%
lf you have no lncome, send a brlef noLe explalnlng how you provlde food, cloLhlng and houslng for your household.

!"#$%O' arenL/Cuardlan musL lnclude conLacL lnformaLlon, slgn, daLe and cerLlfy all lnformaLlon ls Lrue and all lncome ls reporLed.

,-"#P.)*,-33Q%#3*P*23# If the student is homeless, migrant, runaway, or has been placed by the Department of Children and
Family Services with a foster parent or placed in another type of child care facility, please state this information on the application form in
lieu of providing the requested financial information If the student has been placed by the Department of Children and Family Services
with a foster parent or in another child care facility, documentation must be attached t the application verifying the student`s status.

I f your household receives Food Stamps/TANF, and you did NOT receive a letter from OPRF showing direct certification by
July 25, 2013, list all household members and submit a copy of each student`s current certification letter.

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