15CHOSZ 10/22/14
The Federal Government says we are required to ask you for additional information before awarding Federal
Aid and Maryland Grants or Scholarships. If there are differences between your application information and
your financial documents, the Financial Aid Office may need to make corrections electronically and you may
receive a corrected Student Aid Report (SAR).
Instructions: Complete all pages of this form and submit it to HCC Student Financial Aid Office as soon as
possible, so that your financial aid won’t be delayed. Please contact us if you need any additional information to
fill out this form.
Student Information
__________________________________________________
Last Name First Name MI
________________________________
HCC ID Number
Household Size and Number in College
Fill in the chart on the next page after making a selection below:
I am a DEPENDENT student. My household will include:
Yourself.
Your parents (including a stepparent) even if you don’t live with your parents.
Your parents’ other children (Siblings) if your parents will provide more than half of the children’s support
from July 1, 2015, through June 30, 2016, or if the other children would be required to provide parental
information if they were completing a FAFSA for 2015–2016. Include children who meet either of these
standards even if the children do not live with the parents.
Other people if they now live with the parents and the parents provide more than half of the other
people’s support and will continue to provide more than half of their support through June 30, 2016.
I am an INDEPENDENT student. My household will include:
Yourself.
Your spouse, if you are married.
Your children or your spouse’s children, if you or your spouse will provide more than half of the
children’s support from July 1, 2015, through June 30, 2016, even if the children do not live with you.
Other people if they now live with you and you or your spouse provide more than half of the other
people’s support and will continue to provide more than half of their support through June 30, 2016.
All address and phone number
corrections should be made on
WebAdvisor.
Student Financial Aid Office
11400 Robinwood Drive
Hagerstown, MD 21742
finaid@hagerstowncc.edu
FAX: 301-791-9165
2015 – 2016
Household Size
Worksheet
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both
.
15CHOSZ 10/22/14
Please list the persons living in your household; include yourself on the top line.
Full Name Age Relationship
Attending College
6 credits or more? **
(example) Martha Jones 24 wife City University
Self
Number in College: Include information about any household member, excluding the parents, who will
be enrolled at least half time in a degree, diploma, or certificate program at an eligible postsecondary
educational institution any time between July 1, 2015, and June 30, 2016, include the name of the
college.
By signing this form you are certifying that all the information reported on it is
complete and correct.
________________________________________________________________
Student Signature Date
________________________________________________________________
Parent Signature (required for dependent student) Date
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