2018-19 Parent FAFSA Refusal Form

2018-19 Parent FAFSA Refusal Form

You may type your information directly onto this form, print to sign, then submit it to the Office of Student Financial Aid. To avoid processing delays, do not submit this form until you have gathered all required documents/forms requested from you.

Federal regulations give schools the authority to allow a student to borrow a Federal Direct Unsubsidized Loan when the student's parent(s) have ended all financial support and have refused to complete and sign a Free Application for Federal Student Aid (FAFSA). Students who request consideration for the loan should read the information on this form and have one parent complete and sign this form. Note that this form does not allow a student to apply for financial aid as an independent student. Students must understand that they are requesting only an unsubsidized loan subject to the limits for dependent students. No other federal or state financial aid will be available.

Although the Office of Student Financial Aid may waive the requirement for parent income and asset information on the FAFSA, the student must complete and submit a FAFSA that includes all of the required student information and certifications.

Section 1. Student Information

Last name

First name

Middle Initial

UA Student ID #:

Mailing Address

City

State

Note to student: If you meet the conditions shown in Section 2 but your parent will not sign this form, you may submit a letter from a third party (e.g. teacher, counselor, clergy, court) who is familiar with your situation and can describe your relationship with your parents. The letter must be on appropriate letterhead.

Section 2. Parent Information

I attest to the following:

I have stopped providing financial support to the student (including payment of educational costs, as well as all other cash and non-cash support to the student such as room and/or board).

Date support ended:

I will not provide financial support to the student in the future.

I refuse to complete the parental section of a Free Application for Federal Student Aid (FAFSA).

Parent Last name

Parent First name

Parent Middle Initial

Street Address

City

State

Section 3. Certification. Each person signing this worksheet certifies that all of the information reported on it is complete and accurate. Warning: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail, or both.

Student signature: Parent signature:

Date: Date:

Electronic signatures will not be accepted. Please print this form to sign before submitting.

Section 4. Submission.

Do not submit this form until you have gathered all other required documents/forms to avoid delays in processing. When all required documents have been gathered, you may submit your information by: a) mail to the address below; b) fax to 330-972-7139; or c) deliver to the Office of Student Financial Aid, 2nd Floor, Simmons Hall. Watch for two-sided documents. Be sure to include both sides when faxing. Do not email any documents with personally identifiable information.

The University of Akron w Student Financial Aid w Akron, OH 44325-6211 w Fax: 330-972-7139

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