Student Signature. Parent Signature

Transcription

1 Division of Enollment Management S107 Cise Hall Office fo Student Financial Affais PO Box Gainesville, FL / TDD Fax Financial Aid Revision Petition You eligibility fo financial aid was oiginally calculated based on the infomation you povided on the Fee Application fo Fedeal Student Aid (FAFSA). The income and asset infomation that you submitted was evaluated by a fomula called Fedeal Methodology as set by Congess. This fomula assumes that 2016 income is a good pedicto of the family's financial stength duing the student's enollment. Based on this assumption, financial aid eligibility is detemined using 2016 tax etun infomation. The Office of Student Financial Affais at the Univesity of Floida ecognizes that many families expeience changes in income o family situations that ae not eflected in the 2016 tax etun data. Theefoe, it is possible fo students to appeal thei financial aid eligibility if they have special financial cicumstances. An appoved petition cannot be pocessed fo changes until veification is complete. Please check you aid status using ONE.UF ( Log in, choose: Financial Aid> >Aid Status> to detemine if you financial aid file is incomplete fo any eason (missing documents o unmet equiements). Although SFA will eview petitions in Januay 2018, ealy submission is highly ecommended. The deadline to be consideed fo packaging is Decembe 15, A Financial Aid Revision Petition may be filed if you have extenuating cicumstances, which you believe waant a eevaluation of you financial aid. Cicumstances may include, but ae not limited to: Loss o change of employment Loss o change in amount of child suppot, Social Secuity, o othe benefits Divoce o sepaation of paents o spouse Death of paent(s) o spouse Unusual medical expenses (not coveed by insuance) One-time taxable income (e.g. IRA, pension distibution, back-yea Social Secuity payments) Paent attending college (must be enolled full-time in a degee-seeking pogam) Student s paent has etied Change of maital status fo dependent students Cicumstances that ae NOT consideed as extenuating include, but ae not limited to: Standad living expenses (e.g. utilities, cedit cad payments, childen s allowances, etc.) Motgage payments Ca payments Cedit cad o othe pesonal debts Vacation expenses All othe discetionay expenses I cetify that all of the infomation povided on this appeal is tue and complete to the best of my knowledge, and that I have ead and undestood the infomation povided egading the petition pocess. I undestand that I may be equied to povide a copy of my 2016 fedeal income tax etun at a futue date as veification of the infomation povided on this petition. If it is detemined that the pojected income povided was inaccuate, an adjustment to cuent o futue financial aid could esult. Student Name Steet Addess City State Zip Phone Numbe Student Signatue Date Paent Signatue Date

2 Student s Name Financial Aid Revision Petition All students must attach a signed statement asking fo a eevaluation of thei financial aid, explaining thei situation in detail. Additionally, students must indicate below the eason fo thei appeal and submit the equied documentation along with thei petition and statement. Check Box Reason Documentation Loss o change in employment Loss o change in amount of child suppot, social secuity, o othe benefits Divoce o sepaation of paents o spouse Death of paent(s) o spouse Unusual medical expenses One-Time taxable income (e.g. IRA, pension distibution, back-yea Social Secuity payments) Paent attending college (must ceate an extenuating cicumstance) Student s paent has etied Change of maital status fo dependent students who ae maied afte the FAFSA has been filed Pojected Income Woksheet Copy of sepaation notice and final paystub Submit a copy of you and you paents most ecent tax etun tanscipt including W-2s and all schedules If paent has a new job, submit a paystub fom the new job with the YTD eanings. Include beginning date of new job in you witten statement Documentation of unemployment benefits, if applicable Pojected Income Woksheet If benefits ae teminated, povide documentation of the monthly benefit amount eceived and date of benefit temination If benefits ae educed, povide documentation of oiginal amount, date o eduction, and educed amount Divoce ageement Both paents 2016 tax etun tanscipt, W-2s and schedules Household size and numbe in college fom Each paent must submit a Paent Asset Fom If sepaated, documentation showing paents maintain two sepaate households. Pojected Income Woksheet Copy of death cetificate o obituay Copy of 2016 tax etun tanscipt and W-2s, if not aleady submitted Medical Expenses Woksheet Fo 2016 expenses, submit a 2016 IRS 1040 Schedule A if you itemized medical expenses. If you did not itemize, submit poof of payment (e.g. cancelled checks, eceipts, cedit cad statements). Fo 2017 expenses, submit a 2017 IRS 1040 Schedule A. If you did not itemize, o if you have not filed, submit poof of payment (e.g. cancelled checks, eceipts, cedit cad statements). Documentation to identify the souce of income and itemized statement of how that money was spent Copy of 2016 Tax Retun showing the one-time taxable income Pojected Income Woksheet Copy of class schedule and tuition eceipt showing that paent is attending Cetified enollment fom the Regista s Office at the paent s institution Pojected Income Woksheet Documentation of monthly income souces fo all etiement income, including social secuity (if applicable) Maiage Cetificate Student and spouse tax etuns Household size and numbe in college fom Student s Asset Fom Lease o motgage ageement showing student and spouse on the lease o motgage togethe. Othe A pesonal statement and suppoting documentation fo consideation of this petition You statement must clealy identify you special cicumstance and what you ae equesting cust-finaidrevpetition-10-17

3 Financial Aid Revision Petition Pojected Income Woksheet (Use this woksheet to povide pojected income fo a 12 month peiod that most accuately epesents you cuent financial situation.) Student s Name Taxable: Wages, salaies, and tips Unemployment Benefits Paent 1 Paent 2 Student Spouse Pension Alimony Othe (Please Specify) Othe (Please Specify) Non-Taxable: Tax exempt inteest income, IRA contibutions, untaxed IRA distibutions (exclude olloves), untaxed pensions, Wokes Compensation, VA disability, militay o clegy untaxed housing allowances. Child Suppot Othe untaxed income benefits, such as independent student cash suppot (Please Specify) Total anticipated income Cash & Savings Othe (Please Specify) Othe (Please Specify)

4 MEDICAL EXPENSES WORKSHEET Student Name Name of paty esponsible fo payment of medical bills: Relationship to student: : List each medical expense on a sepaate line and attach poof of payment (e.g. cancelled checks, eceipts, cedit cad statements) in line item ode. Include copies of Explanation of Benefits statements fom insuance company, if applicable. ITEMIZATION OF MEDICAL EXPENSES Date of Medical Sevice Name of Medical Povide (hospital, lab, phamacy, docto, etc.) Desciption of Medical Sevices (docto appt., lab wok, pesciption, etc.) Total Cost of Sevices Coveed by Insuance Insuance Will Not Cove Is Bill Paid? (Y/N) If Paid, Date Bill Was Paid cust-finaidrevpetition-10-17

5 Student Name : Date of Medical Sevice Name of Medical Povide (hospital, lab, phamacy, docto, etc.) Desciption of Medical Sevices (docto appt., lab wok, pesciption, etc.) Total Cost of Sevices Coveed by Insuance Insuance Will Not Cove Is Bill Paid? (Y/N) If Paid, Date Bill Was Paid