Student's Name(Required) First Last Student ID Number(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Phone Number(Required)Occasionally family circumstances are such that you are unable to live with and be supported by your biological/adoptive parents. Such circumstances that may warrant a dependency override are: Death Imprisonment Abandonment Abuse Physically or mentally incapacitated parents What does not warrant a dependency override is: Parents’ refusal to contribute to your education Parents’ unwillingness to provide information for the FAFSA Parents do not claim you as a dependent on tax return You (student)demonstrate total self-sufficiency If you think you may be eligible for independent status, the U.S. Department of Education requires documentation to be submitted to the Financial Aid Office in order for the Director of Financial Aid to determine if the circumstances warrant a dependency override. The Director’s decision is final. Please provide the following: Court documentation or police records Written statements from you and two (2) people who can explain your circumstances-and how you have been supporting yourself. The additional 2 statements MUST include one from a non-relative; but the other one can be from: Uninterested 3rd party Adult relative Adult you have lived with during the past year Paster or counselor The statement must include: His/her relationship to you What he/she has witnessed with regards to your situation Signature Phone number where person can be reached If you lived alone, you must provide documentation that demonstrates your ability to support yourself.Upload Supporting Documents Drop files here or Select files Max. file size: 50 MB, Max. files: 8. I certify that all information submitted on and with this form is accurate. I have attached the appropriate supporting documents that might help in determining my dependency status. I understand that the Director of Financial Aid may deny this request.Student's Signature(Required) TweetShareShare
