Office of Financial Aid - Home | JCTC
4231-453082021-22 Special Circumstance RequestOffice of Financial Aid LAST NAMEFIRST NAMEMISTUDENT IDKCTCS E-MAIL ADDRESSADDRESSPHONECITYSTATEZIPThis form is used to re-evaluate your eligibility for 2021-22 financial aid. We will act on your request for a reevaluation only after receiving supporting documentation which confirms your circumstance(s). Please be aware that a re-evaluation does not guarantee an increase in your financial assistance. An increase depends on the availability of funds and demonstrated financial need. Decisions may take 4-6 weeks. I am officially requesting a recalculation of income for the 21-22 school year.? I have provided the following documentation (if selected for verification):? Completed Verification Worksheet? Copies of 2019 federal tax return transcripts/returns ? Copies of 2020 federal tax return transcripts/returns? Copies of my W2s and my spouse’s and parents’ (if applicable) Option 1: Loss or change of employment Student Spouse Parent 1 Parent 2 ? Loss of Employment? ? ? ? ? Change of employment? ? ? ? ? Reduced employment? ? What date did the change occur? ___/_________ I am providing the following documentation to support the change in income: ? Last check stub showing year-to-date income? Termination statement from employer? Statement of unemployment compensation? Statement of loss of unemployment? Other: ______________________________________Briefly provide any further explanation to clarify the changes:? ? Option 2: Death, Divorce, or Separation Student Spouse Parent 1 Parent 2 ? Death? Divorce? SeparationN/A? ? ? ? ?? ? ? ? ? ? What date did the change occur? ___/_________ I am providing the following documentation to support the change: ? Copy of death certificate? Copy of divorce decree? Written, notarized documentation of separationOption 3: Other special circumstances ? Other circumstance Student for ? Spouse ? Parent 1 ? Parent 2 ? What date did the change occur? ___/_________ Describe the special circumstance: I am providing the following documentation to support the change: ? ? ? ? right857250Student Signature: _____________________________________________ Date: _____________________ Parent Signature: ______________________________________________ Date: _____________________ 00Student Signature: _____________________________________________ Date: _____________________ Parent Signature: ______________________________________________ Date: _____________________ I agree that all supplied documentation and information is true and accurate to the best of my knowledge. I understand that requesting a recalculation does not guarantee I will receive grant funds. I understand that income from my spouse, parents (if applicable), and myself, all factor into the formula. I recognize that KCTCS is simply acting as an agent to exclude portions of my income that no longer contribute to my household. right737295Financial Aid Office Use OnlyFA Comment: __________________________________________________________________________________________Signature: ____________________________________ Date: _____________________0Financial Aid Office Use OnlyFA Comment: __________________________________________________________________________________________Signature: ____________________________________ Date: _____________________KCTCS is an equal opportunity employer and education institution ................
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