SPECIAL CIRCUMSTANCE APPLICATION
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1 SPECIAL CIRCUMSTANCE APPLICATION Student Name: Student ID: Address: Street City State Zip Daytime Phone: KSU The purpose of a Special Circumstance application is to explain that the information submitted on the Free Application for Federal Student Aid (FAFSA) is not an accurate representation of the family s financial situation for If approved, an adjustment to your Expected Family Contribution (EFC) may occur. These adjustments will only be made if the income information reported on your 2014 Federal Taxes is greater than your anticipated 2015 income with the exceptions of a parent in college, medical expenses, and secondary educational expenses. For a review of your Special Circumstances, you must: Complete the Verification process, if you are selected, this process must be completed before the Special Circumstance Application can be reviewed. The student must be admitted and meet all federal eligibility requirements when the Special Circumstance application is received. Meet one of the Circumstances listed on the following pages. Failure to furnish all the required documentation when submitting the application will delay the review process and/or result in the denial of your request. If the circumstance only pertains to the parent(s), we still take into consideration the student s 2015 anticipated income. Please include documentation for all individuals listed on the FAFSA. Understand an adjustment to the Expected Family Contribution might not result in additional financial aid. The application deadline is February 1, CERTIFICATION STATEMENT Must be signed by the student, the student s spouse, and the student s parents (if applicable) All information on this application is true and complete to the best of my knowledge. If requested, I agree to provide further documentation to substantiate the information provided. I understand that any false information may result in cancellation of any current or future financial aid award(s) and that I may be required to repay any financial aid that was awarded based on the recalculation of the Expected Family Contribution (EFC). Student Signature Date Student s Spouse Signature Date Parent 1 Signature Date Parent 2 Signature Date 1
2 Only the Individual(s) not filing 2014 Federal taxes should sign below. IF YOU DID NOT FILE FEDERAL TAXES FOR 2014 PLEASE SIGN THE NON-FILING STATEMENT If you received a 2014 IRS W-2 or 1099, provide a copy with this application. Student Signature Date Student s Spouse Signature Date Parent 1 Signature Date Parent 2 Signature Date Important Information and Instructions: Submit all required documentation under the section(s) that match your circumstances. Instructions on how to retrieve and print your 2014 Federal IRS Tax Return Transcript listed on Page 6. Please note you will not need to submit State Taxes to complete this process. Complete and return pages 1-6 with all required supporting documentation to the Student Financial Aid Office at the Kent campus. All Special Circumstance Applications are reviewed and processed in the date order in which they are received at the Student Financial Aid Office. Processing of this application takes 2-3 weeks from the time all requested documents have been received. You will still be held responsible for any balances owed to the University while waiting for this application to be reviewed. Messages related to the Special Circumstance Application will be posted to the student s FlashLine account at Directions on how to view your messages can be found on our website at Please check box if student was selected for Verification. ** If all 2014 Federal tax documents were submitted to the Student Financial Aid Office as a result of Verification, you are not required to submit a second copy. ~PLEASE CHECK THE REASON FOR YOUR SPECIAL CIRCUMSTANCE PROVIDE ALL ADDITIONAL DOCUMENTS LISTED BELOW YOUR SITUATION. Loss or Reduction of Working Income: Please circle individual with the loss or reduction Parent 1 Parent 2 Student Spouse Letter of separation from employer that states the last day of employment. You must be laid off at least 10 weeks prior to submitting this application. If reduced hours/wages or job loss, a current or most recent paystub showing reduced hours with Year-to-date amount. You must submit final 2015 pay check(s) from all employer(s). Copy of unemployment statement with weekly amount, unemployment check stub or statement of ineligibility for unemployment benefits. You must submit final 2015 pay check(s) from all employer(s). Copy of severance etc., include documentation of total payments anticipated/received between Jan Dec 2015 Student & Spouse Federal IRS Tax Return Transcript. Submit both Transcripts, if filed separately. Student & Spouse W-2s for all employers. W-2s must equal wages entered on Federal tax forms. W-2 is required even if student or Parent/Stepparent(s) Federal IRS Tax Return Transcript. Submit both Transcripts, if filed separately. If you have a home-based business, please submit a signed statement of projected income for Jan- Dec Security Income, Untaxed Income, and Disability Income). (Continued from page 2) 2
3 Loss of Benefits or Untaxed Income: Please circle below Alimony Child Support Workman s Comp Social Security/Disability Unemployment Court documents, legal separation or divorce decree stating effective date of change. Letter from agency stating last date of payment and total amount received/anticipated from Jan-Dec Parent/Stepparent(s) Federal IRS Tax Return Transcript. Submit both Transcripts, if filed separately. Divorce/Separation: Must have occurred after submitting the FAFSA. Incomes will be used for both parents up to the separation date. A copy of legal separation/divorce decree, letter from attorney stating the separation or divorce date. Documentation showing separate addresses, such as utility bills, lease, etc. from the current month. Death of a Parent or Spouse: A copy of death certificate, obituary or death notice. Lump sum Income or Pension/401k Withdrawal included in 2014 Adjusted Gross Income and reported on the FAFSA Note: This is a one-time special circumstance consideration. Second year requests will be denied. Received an inheritance or withdrew a lump sum pension/ira/social security payment in Documentation that identifies source of income or withdrawal of funds and the amount for 2014, listed on Federal taxes. Documentation on how funds were spent or invested and why they are not available as a resource for Please submit paid invoices, canceled checks, and/or receipts. Spent funds will be reviewed. If funds were used for luxury items, vacation, home renovations, and/or standard living expenses (related to mortgage, utilities, credit card expenses, college tuition) the application will not be approved. 3
4 (Continued from page 3) Lump Sum Income Medical/Dental or Elementary/Secondary Tuition Expenses: Cannot claim College tuition. A copy of 2014 Schedule A, canceled checks, or receipts indicating amounts that have been paid for (not billed) by you (not your insurance company) in Expenses have to equal or be greater than 10% of your 2014 household adjusted gross income. A letter from K-12 school stating amount paid by you for This does not include scholarships or grants received Jan Dec Paid tuition expenses have to equal or be greater than 10% of your 2014 household adjusted gross income. Parent in College with at least half-time enrollment: Total number of family members in college? Copy of the parent s tuition bill for the Summer 2015, Fall 2015, or Spring 2016 term. Student & Spouse Federal IRS Tax Return Transcript. Submit both Transcripts, if filed separately. Use this section to provide a detailed explanation of what has changed for the family financially since the end of Include dollar amounts, dates, and attach appropriate documentation to support reasons for filing the Special Circumstance Application. 4
5 Special Circumstance Projected 2015 Income Worksheet Report all expected income for all members of your family Part A: Total 2015 Gross Taxed Income Student Spouse Parent 1 Parent 2 Wages and salaries $ $ $ $ Alimony received $ $ $ $ Business &/or Farm Income $ $ $ $ Capital Gains $ $ $ $ Pensions and Annuities $ $ $ $ IRA Distributions (Excluding rollovers) $ $ $ $ Rental Income $ $ $ $ Taxable Social Security Benefits $ $ $ $ Unemployment Compensation $ $ $ $ TOTAL TAXED INCOME FOR 2015 $ $ $ $ Part B: Total 2015 Gross Untaxed Income Student Spouse Parent 1 Parent 2 Payments to Tax deferred Pensions such as 401(k) or 403 (b) $ $ $ $ IRA, Keogh, &/or SIMPLE payment $ $ $ $ Social Security Benefits $ $ $ $ Child Support Received $ $ $ $ Public Assistance (Welfare, TANF, WIC) $ $ $ $ Disability, Death Pension, Worker's Compensation $ $ $ $ Other $ $ $ $ TOTAL UNTAXED INCOME FOR 2015 $ $ $ $ 5
6 Printing Your Federal IRS Tax Return Transcript 1. Go to 2. Choose Get Transcript of your Tax Records. 3. You will have the option to access your transcript online or request one to be mailed to you. To view and print your transcript immediately, click on the Get Transcript Online option: _ 4. First time users must click Create an Account. Complete the required name and fields and click Send Confirmation Code. 5. Wait to receive your confirmation code via the address you listed. This may take a few minutes. 6. Once you have your confirmation code, enter the code in the Enter Confirmation Code box and click Verify Confirmation Code. 7. Complete the personal information questions on the next screen then click Continue to sign in as a guest for a one-time use of the site. 8. After you click continue, you will be brought to a screen that will present you with questions that must be answered correctly so that irs.gov can validate your identity. Once you answer the questions, hit continue: (NOTE: If you are unable to answer all of the questions correctly, you will be forced to start from the beginning.) 9. If all questions were answered correctly, you will be given the opportunity to select the transcript information. Select the reason as Higher Education/Student Aid then select the correct year for the Return Transcript you are attempting to print. You may have to allow pop-ups in order to view the final printable transcript. 10. You will be presented with a tax transcript that can either be printed or saved as a PDF (depending on which internet browser you used). If you are unable to complete the identity verification steps, use the Get Transcript by Mail option. You may also call the IRS s automated phone transcript service at to receive it by mail. Submit to: Student Financial Aid Office Phone: (330) Attn: Professional Judgment Fax: (330) East Summit Street Location: 103 Schwartz Center P.O. Box finaid@kent.edu Kent, OH Website: For Office Use Only: Prior Year Application? Yes No Verify prior ROANYUD Yes No Application Decision Approved Denied Calculation RNANA15 > 75% of 2014 AGI listed on taxes Revised 3/31/2015 6
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