SPECIAL CIRCUMSTANCES APPLICATION

Transcription

1 R Student Rocket Number Student Last Name Student First Name SPECIAL CIRCUMSTANCES APPLICATION COMPLETE WITH BLACK INK ONLY. ELECTRONIC SIGNATURES ARE NOT ACCEPTABLE ON THIS FORM. If the information you reported on your Free Application for Federal Student Aid (FAFSA) does not reflect your current financial situation or does not take into account an unusual circumstance that has resulted in a significant and prolonged decline in family income, complete this application to request a review of your financial aid eligibility that includes this information. Please be aware that not all special circumstance adjustments result in additional financial aid. Once all required documentation is received, allow 6-10 business days for processing. Applications received from the beginning of August through mid-september may take longer to review. If your Special Circumstances Application has not been processed prior to your bill due date, it is your responsibility to make alternative payment arrangements, if necessary. This application and all required documentation must be received by the Office of Student Financial Aid no later than February 15, 2019, to receive consideration for the academic year. Please write your Student Rocket Number on all documents being submitted. CIRCUMSTANCES THAT WILL BE CONSIDERED: Loss of employment or an employment change resulting in a reduction in earnings One-time, lump sum 401K/pension withdrawal included in 2016 adjusted gross income and used for emergency purposes Loss of unemployment or disability benefits Loss of untaxed income such as child support, workers compensation, or social security benefits Divorce or legal separation after the FAFSA was filed Death of a parent or spouse after the FAFSA was filed High unreimbursed medical and/or dental expenses incurred in 2016 Private elementary or secondary tuition paid out-of-pocket in 2016 CIRCUMSTANCES THAT CANNOT BE CONSIDERED: Income reductions due to loss of overtime pay, bonuses, or commissions Income changes due to fringe benefit adjustments such as paid days off, holiday pay, employer-provided insurance coverage, etc. Loss of windfall income such as lottery or gambling winnings High consumer debt SECTION 1: DESCRIPTION OF SPECIAL CIRCUMSTANCES Explain the change in your and/or your family s financial situation: SPCAP

2 SECTION 2: ESTIMATED INCOME FOR 2018 (JANUARY 1, 2018 TO DECEMBER 31, 2018) DEPENDENT STUDENTS: INDEPENDENT STUDENTS: Provide information about you and the parent(s)/stepparent whose information was provided on the FAFSA. Provide information about you and your spouse (if married). SOURCE OF INCOME PARENT 1 PARENT 2 STUDENT SPOUSE Gross wages, salaries, severance pay, tips $ $ $ $ Unemployment benefits $ $ $ $ Retirement benefits/pension $ $ $ $ Workers compensation $ $ $ $ Other income: $ $ $ $ CERTIFICATION STATEMENT: I (We) certify that all of the information provided on this application is true and complete to the best of my (our) knowledge. I (We) understand that further documentation may be requested by the Office of Student Financial Aid before a final decision is made, and that not every documented situation will result in a change in financial aid eligibility. Student Signature Parent Signature RETURN THIS FORM BY: Mail: The University of Toledo Office of Student Financial Aid 2801 West Bancroft Street, Mail Stop 314 Toledo, Ohio Fax: Approved For office use only Upload: myut.utoledo.edu My Financial Aid Secure Financial Aid Document Upload Denied Questions? Please contact Rocket Solution Central (RSC) at OSFA Signature SPCAP

3 SECTION 3: REQUIRED DOCUMENTATION FOR ALL APPLICANTS NOTE: If you have already submitted one or more of these documents, you are not required to resubmit them. DEPENDENT STUDENTS Verification Worksheet available at utoledo.edu/financialaid/forms.html A copy of your 2016 Federal Tax Return Transcript.* The transcript can be requested at irs.gov/transcript. If an amended tax return was filed, attach a signed copy of the 2016 IRS Form 1040X Copies of all of your 2016 W-2s A copy of your parents 2016 Federal Tax Return Transcript(s).* The transcript can be requested at irs.gov/transcript. If your parents did not, will not, and are not required to file a 2016 Federal Tax Return, attach a copy of your parents 2016 IRS Verification of Non-filing Letter(s). This letter can be requested at irs.gov/transcript. If an amended tax return was filed, attach a signed copy of the 2016 IRS Form 1040X Copies of all of your parents 2016 W-2s All supporting documentation pertaining to your situation as described in SECTION 4 *The Federal Tax Return Transcript is required even if tax return information was transferred to your FAFSA using the IRS Data Retrieval Tool. INDEPENDENT STUDENTS Verification Worksheet available at utoledo.edu/financialaid/forms.html A copy of your and your spouse s (if married) 2016 Federal Tax Return Transcript.* The transcript can be requested at irs.gov/transcript. If you or your spouse (if married) did not, will not, and are not required to file a 2016 Federal Tax Return, attach a copy of your and your spouse s (if married) 2016 IRS Verification of Non-filing Letter(s). This letter can be requested at irs.gov/transcript. If an amended tax return was filed, attach a signed copy of the 2016 IRS Form 1040X Copies of all of your and your spouse s (if married) 2016 W-2 s All supporting documentation pertaining to your situation as described in SECTION 4 *The Federal Tax Return Transcript is required even if tax return information was transferred to your FAFSA using the IRS Data Retrieval Tool. SECTION 4: SUPPORTING DOCUMENTATION Submit the documentation listed for any of the following circumstances that are applicable to you. Your application will not be reviewed until ALL documentation has been received. LOSS OF EMPLOYMENT A copy of your termination letter from your employer or a letter from each past employer confirming your last date of employment and 2018 year-to-date earnings A copy of your unemployment benefits letter stating when benefits began and the weekly amount received or a copy of your claimant inquiry letter from the unemployment office that includes your weekly benefit amount, current eligibility status, and 2018 year-to-date earnings DISLOCATED WORKER - submit documentation applicable to your circumstances as described below: LAID OFF OR RECEIVED A LAY-OFF NOTICE A copy of your termination letter from your employer indicating that the layoff was the result of a permanent closure of or substantial layoff at a plant, facility, or enterprise SPCAP

4 or a letter from each past employer confirming your last date of employment and 2018 year-to-date earnings A copy of one of the following: 1. Your unemployment benefits letter stating when benefits began and the weekly amount received 2. Your claimant inquiry letter from the unemployment office that includes your weekly benefit amount, current eligibility status, and 2018 year-to-date earnings 3. Your unemployment benefits termination letter SELF-EMPLOYED BUT UNEMPLOYED DUE TO ECONOMIC CONDITIONS OR NATURAL DISASTER A written statement explaining the cause of unemployment Supporting documentation to substantiate your statement SPOUSE OF ACTIVE DUTY MEMBER OF U.S. ARMED FORCES WHO IS UNEMPLOYED OR UNDEREMPLOYED DUE TO A PERMANENT CHANGE IN DUTY STATION Copy of the service member s orders showing the change in duty station REDUCTION IN EARNINGS - submit documentation applicable to your circumstances as described below: REDUCTION IN EARNINGS DUE TO EMPLOYMENT CHANGE A copy of your termination letter from your employer or a letter from each past employer confirming the last date of employment and 2018 year-to-date earnings A copy of your most recent 2018 pay stub from your new employer A letter from your new employer stating your new rate of pay, average hours worked per week, and date of hire REDUCTION IN EARNINGS WITH THE SAME EMPLOYER A copy of your most recent 2018 pay stub A letter from your employer stating your new rate of pay, average hours worked per week, and effective date ONE-TIME, LUMP SUM 401K/PENSION WITHDRAWAL INCLUDED IN 2016 ADJUSTED GROSS INCOME A copy of the 2017 Federal Tax Return Transcript for the person who made the withdrawal. The transcript can be requested at irs.gov/transcript. Documentation (including receipts, if applicable) identifying the source of the income, how the funds were spent, and the amount of any remaining funds LOSS OF UNEMPLOYMENT BENEFITS A copy of your unemployment benefits termination letter A copy of your claimant inquiry letter from the unemployment office that includes your weekly benefit amount, current eligibility status, and 2018 year-to-date earnings LOSS OF DISABILITY BENEFITS A letter from your employer that includes the date disability benefits ended, 2018 year-to-date earnings, and whether or not you will be returning to work A copy of your workers compensation benefits letter stating the amount of benefits you will receive, if applicable A copy of your Social Security benefits letter stating the amount of benefits you will receive, if applicable DIVORCE OR LEGAL SEPARATION A copy of the divorce or legal separation papers or a letter from your attorney stating the marital status of the parties involved Documentation of alimony and/or child support received SPCAP

5 DEATH OF PARENT OR SPOUSE after the FAFSA was filed A copy of the death certificate LOSS OF CHILD SUPPORT A letter from the Child Support Enforcement Agency stating the date of the emancipation of the child Documentation from the Child Support Enforcement Agency stating the monthly amount of child support received prior to emancipation If you will continue to receive child support for other minor children, documentation from the Child Support Enforcement Agency stating the new monthly amount you will receive LOSS OF WORKERS COMPENSATION BENEFITS A copy of your Workers Compensation benefits termination letter Documentation of the monthly amount of benefits received prior to termination MEDICAL/DENTAL EXPENSES not covered by insurance and paid out-of-pocket A copy of your 2016 IRS Schedule A, if you itemized deductions on your Federal Tax Return If you did not file a 2016 IRS Schedule A, submit an itemized list of medical/dental expenses paid out-of-pocket in 2016 with copies of paid receipts or canceled checks for each expense listed. Please note: An Explanation of Benefits (EOB) form from your insurance company is not acceptable as proof of payment. PRIVATE ELEMENTARY/SECONDARY TUITION OR COLLEGE TUITION FOR A PARENT paid out-of-pocket Receipts or statements from the schools(s) for the academic year indicating the amount paid and for whom. Tuition paid by grants, scholarships, fee waivers, or tuition reimbursement will not be considered. Private school tuition paid for the entering University of Toledo student will not be considered. College tuition paid for a parent must have been paid in summer 2016, fall 2016, winter 2017, and/or spring SPCAP