2007-2008 Appeal for Financial Aid as an Independent Student

· CAYUGA COMMUNITY COLLEGE ·

Financial Aid Office · Auburn 315-255-1743 ext. 2470 · Fulton 315-592-4143 ext. 3004 · FAX 315-252-2185

2008-2009 Appeal for Financial Aid as an Independent Student

(Please read this form carefully. Filing this form does not guarantee that your appeal will be approved.)

______________________________________________________________________________________

Last Name First Name M. I. Social Security #

______________________________________________________________________________________

Street City State Zip

__________________________ C__________________________

Phone Banner ID Number

You are considered an INDEPENDENT STUDENT for Financial Aid purposes if you meet one of the following conditions at the time you complete and sign the 2008-2009 Free Application for Federal Student Aid (FAFSA):

· You will be 24 years old by December 31, 2008. (Born before January 1, 1985)

· Your parents are both deceased or you are an orphan or ward of the court.

· You are a veteran of the U.S. Armed Forces.

· You are currently serving on active duty in the U.S. Armed Forces for purposes other than training.

· You are a graduate student working on a post-baccalaureate degree.

· You are married.

· You have children who receive more than half of their support from you.

· You have legal dependents, other than a spouse, who meet the definition of a legal dependent found in the FAFSA instructions.

*Note: If you meet one of the above conditions, you do not need to complete this form.

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A. Reasons for Appeal

Many students feel they are independent because they currently live on their own, or because their

parents refuse to provide information on the FAFSA, or because their parents cannot afford to help

with college expenses. However, these reasons are not sufficient for an appeal.

The Financial Aid Office is required to consider parent information and expect a parental contribution

for students who are not independent according to the above FAFSA definition, unless exceptions are

made. Exceptions are made only when adequate documentation of extenuating family

circumstances exist. Extenuating circumstances are generally defined by a student’s inability to

have contact with his or her parents.

Review the following reasons for appeal and check the one that describes your circumstance. If

none of these circumstances apply to your situation, do not complete this form.

1. Severe circumstances within your family prevent you from obtaining your parents’

financial information. Examples:

(a) an abusive home situation which is detrimental to your physical or mental well-being

(b) abandonment by both parents

(d) incarceration of the custodial parent and inability to obtain other parent’s information

(e) other extenuating circumstances not described above

2. Death of a parent after filing the FAFSA and the surviving parent meets one of the severe

circumstances listed above.

B. Personal Statement and Documentation

Attach a written personal statement (preferably typed) which completely and explicitly explains the

the basis of your appeal. Please note that your statement will be used only to determine if a

dependency exception should be made. This information will be held in strictest confidence.

Make sure your statement is signed and dated. Attach at least one acceptable source of documentation

which verifies all the facts of your appeal. Acceptable sources of documentation are listed below according

to the reason for your appeal.

1. If you checked Reason #1, provide one or more of the following acceptable sources:

Signed statements from an adult professionals who is not family member, which

verify the family circumstances described in your personal statement. Adult pro-

fessionals include clergy members, attorneys, school guidance counselors, medical

doctors, mental health professionals, teachers or professors, law enforcement officers,

professional staff of Children and Family Services (Public Assistance Department)

and officers of the court. Letters must be signed originals on agency letterhead with

the professional’s title (Counselor, Rabbi, etc.).

2. If you checked Reason #2, provide one of the above sources and a photocopy

of your parent’s death certificate or newspaper obituary.

D. Additional Information (Answer all five questions)

1. In what year were you last claimed by your parent(s) as a dependent on a Federal Tax Return?

(1040 or 1040A) Year ______________

2. When did you last live with your parent(s)? ______________________

Month/Year

3. When did you last receive financial support from your parent(s)? ______________________

Month/Year

4. Are you included as a dependent under your parent’s medical plan? ____________________

Yes or No

5. Did you file a 2007 Federal Tax Return (1040, 1040A, 1040EZ or 1040TEL)? ___________

Yes or No

E. Student Certification (Read carefully before you sign)

I hereby certify that all information contained in this appeal for independent status, including

my personal statement and other documentation, is true and complete to the best of my

knowledge. I swear or affirm that I have not knowingly or intentionally provided any false

statements or fraudulent documentation. I understand that if I am found to have knowingly

or intentionally given false or fraudulent statements and/or documentation, my appeal will be

denied and my eligibility for Federal and State student aid jeopardized.

_______________________________________________ _________________________

Signature Date

Please return this form to the Financial Aid Office at Cayuga Community College,

197 Franklin St., Auburn, NY 13021-3099.

____________________________________________________________________________________________

Results of Appeal _________________________________________________

FAA Signature _________________________________________________Date_______________________

bpr Rev. 1/08