2017-2018

Dependency StatusAppeal

For Office Use Only

Approved ____ Denied _____ Date ______

Please read carefully before continuing:

Federal regulations require that students under the age of 24-years file the Free Application for Federal Student Aid (FAFSA) using the financial information for themselves and their parent(s). Unless you meet one of the government’s exemptions to this rule (see list on back of this form), you are required to supply this information.

A dependency status appeal will only be considered for those students that have mitigating circumstances and can prove: 1) that their income is sufficient to be self-supporting and, 2) that there is a valid reason why their parent should not be expected to make their federally expected contribution to the student’s educational costs.

The following situations are not, by themselves, sufficient reasons to grant an appeal:

*Your parents are unwilling to share financial information on the FAFSA *You and your parents do not “get along” *Your parents refuse to contribute to your college expenses *You do not live with your parents

Name: ______ID# or SSN: ______

Address: ______City: ______State: ______Zip: ______

Telephone Number: Home/Cell (______) ______Work (______) ______

  1. During the 2017-2018 academic-year you will be living:

with parents with relativesin an apartment (attach copy of lease).

other (Explain-use back if necessary): ______

  1. Mother’s name and address:______
  2. Father’s name and address: ______
  3. Did you receive financial aid in the 2016-2017year as an independent student?  Yes No
  4. You are required to submit copies of your 2015 and 2016 federal tax returns as well as a copy of your parent(s) 2016 federal tax return with this application. If you are not submitting one or more of these tax returns, please explain the reason why.
  5. You are required to submit a copy of your 2016 Illinois State tax return or a copy of a driver’s license if issued before 8/16/16.
  6. If you have a child and are living with the child’s other biological parent, you must submit a copy of his/her 2016 tax return.
  7. If you are living in a home you own or an apartment you rent, you must attach a copy of your mortgage statement or your apartment lease, with contact information for your landlord.
  8. On a separate sheet of paper, please write an explanation as towhy you believe you should be considered for financial aid as an independent student. Make sure to explain how you support yourself and why your parent(s) should be exempt fromcontributing to your educational expenses.
  9. Attach any additional documentation that might support your appeal. Examples include:third party documentation from a court, social worker, school counselor, homeless shelter, clergy member, or law enforcement agency.

I hereby affirm that all information on this form and any attachments are true, complete, and accurate to the best of my knowledge. I understand that any false statements or misrepresentation will be cause for denial, reduction, withdrawal, and/or repayment of financial aid, and may subject the filer to a fine or imprisonment or both, under the provisions of the United States Criminal Code.
Student’s Signature: ______Date: ______

If you can answer “YES” to any of the questions belowyou should contact the IVCC Financial Aid Office prior to submitting the Dependency Status AppealForm.

  • Were you born before January 1, 1994?
  • As of today, are you married? (Also answer “Yes” if you are separated but not divorced.)
  • At the beginning of the 2017-2018 school year, will you be working on a master’s or doctorate program (such as an MA, MBA, MD, JD, PhD, EdD, graduate certificate, etc.)?
  • Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training?
  • Are you a veteran of the U.S. Armed Forces?
  • Do you now have or will you have children who will receive more than half of their support from you between July 1, 2017 and June 30, 2018?
  • Do you have dependents (other than your children or spouse) who live with you and who receive more than half of their support from you, now and through June 30, 2018?
  • At any time since you turned age 13, were both your parents deceased, were you in foster care or were you a dependent or ward of the court?
  • As determined by a court in your state of legal residence, are you or were you an emancipated minor?
  • As determined by a court in your state of legal residence, are you or were you in legal guardianship?
  • At any time on or after July 1, 2016, did your high school or school district homeless liaison determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless?
  • At any time on or after July 1, 2016, did the director of an emergency shelter or transitional housing program funded by the U.S. Department of Housing and Urban Development determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless?
  • At any time on or after July 1, 2016, did the director of a runaway or homeless youth basic center or transitional living program determine that you were an unaccompanied youth who was homeless or were self-supporting and at risk of being homeless?