2018-2019 Financial Aid Appeal Form and Guidelines

[Pages:2]Office of Financial Aid 2130 Fulton Street

San Francisco, CA 94117 Phone: 415.422.2020 | Fax: 415.422.6084

2018-2019 Financial Aid Appeal Form and Guidelines

Recognizing that the information collected by the

2018/2019 Free Application for Federal Student Aid

STUDENT INFORMATION

(FAFSA) and/or CSS Profile does not always reflect an

applicant's current financial circumstances, the Office Last Name

First Name

M.I

of Financial Aid may re-evaluate eligibility for student

aid when specific circumstances have occurred in 2016.

Street Address

Once we review your appeal and determine whether an adjustment can be made, we will notify the student of the outcome. If changes are made to the student's financial aid package, the student will receive a revised award email notification. Response time will vary based on our volume of appeals.

USF is unable to consider appeals that are based on the following: Private school tuition, IRA withdrawal to meet expenses, gambling loss/winning, capital gain received as income, personal debts/liens/garnishments, termination for cause, and financial support for others not allowed on FAFSA.

City

State

Zip Code

USF Student ID Number (CWID) __________________

Tax Verification Required

j

18/19 Verification Worksheet (Ind or Dep)

2016 Tax Transcript

2016 W-2's or Wage and Income Transcripts

Submitting an appeal will automatically select your file

for a review process called verification. If not

previosuly completed, along with the appeal form,

please complete financial aid verifcation.

A. Involuntary loss of household income

Student/Spouse

Parent (s)

Loss of employment Pay cut or furlough Loss of benefits (Disability or Social Security) Loss of Child Support Separation/Divorce

? Letter explaining your change in circumstances ? Termination/Severance Notice ? Documentation of loss of benefits ? Copy of unemployment statements ? Copy of most recent paystub

B. One Time/ Non Recurring Income

IRA Rollover Sale of Property Inheritance

Student/Spouse

Parent (s)

? Provide a statement of how the income was used with documentation.

C. Unreimbursed Medical / Dental Cost Total Amount $__________

Student/Spouse

Parent (s)

? Letter explaining your circumstances ? Supporting documentation ? Receipts, Billing Statements, etc.

D. Death After FAFSA Completed

Spouse

Parent (s)

? Letter explaining your circumstances ? Copy of Death Certificate

STUDENT NAME: ________________________________

E. CURRENT SOURCES OF INCOME- MONTHLY STUDENT/SPOUSE

PARENT(S)

F. Statement- or attach letter

STUDENT CWID: ______________________

$ $ $

$ $ $

Signature and Certification

By signing this worksheet, I certify that all information reported on this worksheet is complete and correct under penalty of perjury. If you purposely give false or misleading information, you may be fined, sent to prison, or both.

_________________________________________________ Parent's Signature

_________________________________________________ Student's Signature

_________________________________ Date

_________________________________ Date

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