Semester/Award year 2005-2006



REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES

ACADEMIC YEAR 2008-2009

This is a follow up to your conversation with the Office of Financial Aid and Scholarships concerning a request for consideration of special circumstances during the 2008-2009 academic year. Please complete the enclosed application, attach the required documentation and submit the original to the receptionist in the Office of Financial Aid and Scholarships.

*PLEASE FORWARD THE COMPLETED APPLICATION PACKET TO THE FINANCIAL AID OFFICE

REQUEST FOR CONSIDERATION OF

SPECIAL CIRCUMSTANCES

ACADEMIC YEAR 2008-2009

When applying for financial aid, student aid regulations require students and parents to provide information concerning the most recent tax year. Unforeseen circumstances can sometimes alter the financial picture of the family’s ability to meet educational expenses. The purpose of this form is to provide the framework for the financial aid administrator to consider changes to previously reported information on the 2007 FAFSA. If approved, we will use only available funding from the federal aid programs, to include loans, grants, and in some cases, federal work study. There are no UNIVERSITY-BASED FUNDS associated with your appeal.

Please note that budgetary restrictions and other program guidelines limit our ability to cover all of your educational expenses. In many instances, we may not be able to provide any FEDERAL grant funding whatsoever. As such, we cannot guarantee the amount of your award (if approved) will be sufficient to meet your unmet educational expenses. Please note that this is a one-time only (if approved) award.

You must provide adequate documentation, a notarized letter carefully explaining your reason for your special circumstances. **By law, the financial aid administrator must have compelling reasons to use professional judgment to make adjustments because of special circumstances. The law also provides the financial aid administrator with the final decision as to whether the special circumstances appeal is approve; the decision cannot be appealed to the U.S. Department of Education.

Please note: All appeals will be reviewed in August. As such, you must meet all applicable payment deadlines irrespective of your request for consideration of special circumstances.

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*The above list is not an exhaustive example of appeals which may be considered.

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EXPECTED 2008 INCOME

Please complete this portion of the form. Enter the information required in the appropriate column(s). Some columns or line items may not be applicable to you.

Please remember to attach a copy of your 2007 Federal Tax Return and supporting schedules. You must attach documentation, with appropriate signatures. Without the supporting documentation, your request will be denied.

Father Mother Student Spouse

Actual Gross Income Earned from Work: __________ ________ _________ ____________

January 1, 2008 to present

Expected Gross Income Earned from Work: ___________ _________ __________ _____________

Present to December 31, 2008

Total earned and expected earned income: ____________ __________ ___________ ____________

Other taxable income: _____________ __________ ___________ ___________

Examples: Interest, alimony,

Worker’s Compensation, Unemployment, Child Support, Social Security Benefits, Capital Gains, etc…

Untaxed Income:

Please indicate the amount (s) and type(s) of untaxed income received. Examples include Child Support, Military Allowances, Welfare, Aid to dependent Children (ADC), Social Security Benefits or Disability. Please also note any cash you received or money paid on your behalf (such as bills) not reported elsewhere.

Source(s) of Untaxed Income Amount Received 1/1/2008 Expected Amount Received

to the present Present to 12/31/2008

---------------------------- ------------------------------ ---------------------------------

---------------------------- ------------------------------ ---------------------------------

---------------------------- ------------------------------ ---------------------------------

---------------------------- ------------------------------ ---------------------------------

--------------------------- ------------------------------ ---------------------------------

Asset Value and Net Worth:

Please indicate the amount of savings or checking accounts and the net worth of investments or businesses. Net worth means current value minus current debt.

Father Mother Student Spouse

Cash, savings and checking account ----------------- --------------- ------------------ -------------------

Investments ------------------ --------------- ------------------ -------------------

Business or Investment Farm ------------------- ---------------- ------------------ --------------------

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CERTIFICATION

I/We certify that the foregoing information provided in this Special Circumstances Petition is true and complete to the best of my/our knowledge. I/We agree to provide additional information if asked by the Financial Aid Administrator. I/We further acknowledge that the penalty for providing false or misleading information is a 10,000.00 fine, imprisonment, or both fine and imprisonment. The aforementioned is punishable by the U.S. Department of Education, or its designee(s). I understand that special circumstance petitions, if granted may not be sufficient to cover all education expenses. Please note that loans are also considered financial aid.

I ALSO UNDERSTAND THAT I CAN BE APPROVED ONLY ONCE FOR THE SAME SPECIAL CIRCUMSTANCE.

Student SSN: ___________________ Student Name: _________________________

Father: _________________________ SSN: ____________________________

(if applicable)

Mother: ________________________ SSN: ____________________________

(if applicable)

FINANCIAL AID OFFICE USE ONLY

Prior year special circumstances: Yes_______ No________

SPECIAL CIRCUMSTANCES:

APPROVED: _____________ Old EFC______________ New EFC___________

DENIED: ______________

Comments: ___________________________________________________________________________

___________________________ _________________________

Financial Aid Administrator Date

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Examples of Appeals:

1) Tuition expenses at an elementary or secondary school;

2) Medical or dental expenses not covered by insurance;

3) Unusually high child care costs;

4) Retired during the current year;

5) Job loss or unemployment, or student’s or parent’s income has decreased significantly since completing the FAFSA;

6) The student or parent no longer receive untaxed benefits as reported on the FAFSA;

7) The student or his/parents separated or divorced after filing the FAFSA;

8) Homelessness;

9) Dislocated worker;

10) Students from families who transfer funds from regular IRA accounts to Roth IRA Accounts, and

11) Other.

(Please circle the appropriate example(s) appropriate to

your circumstance).

Documentation required (in above order listed):

1) Provide a letter from the school with current year’s expenses;

2) Provide a copy of the insurance policy and proof of out-of pocket expenses;

3) Provide a notarized letter from the child care provider;

4) Provide a letter from the personnel office, a copy of final pay stub, documentation of severance pay. Please also provide documentation of monthly income sources for retirement income, including social security benefits;

5) Provide a letter from the personnel office and a copy of the final pay stub received, a copy of unemployment received, and a statement of current and future anticipated earnings, including non-taxable earnings;

6) Provide a copy of letter from appropriate agency indicating the date the benefits ended. Also provide the date through which the benefit was received and the amount received year-to date- at the termination of the benefit. Provide a copy of most recent pay stub;

7) Provide a copy of spouse’s tax return (if filing separately), all W-2s; a letter indicating the date of separation and indicating the parent providing primary financial support. A statement indicating the monthly support be given or received should also be submitted;

8) Provide a letter from the local homelessness shelter and/or agency; or provide at least three notarized statements from unrelated individuals who can attest to your status;

9) Provide copies of 2006 and 2007 Federal Income Tax Returns and supporting schedules, and

10) Provide documentation from banking institution(s).

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