16CHOSZ 1/21/2016
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, 2016, through June 30, 2017, or if the other children would be required to provide parental
information if they were completing a FAFSA for 2016–2017. 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, 2017.
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 and/or your spouse will provide more than half of the
children’s support from July 1, 2016, through June 30, 2017, even if the children do not live with you.
Other people if they now live with you and you and/or your spouse provides more than half of the other
people’s support and will continue to provide more than half of their support through June 30, 2017.
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. Please fill out this form in your browser and then print and sign. We require ink
signatures on this form. Required fields are outlined in red. Please contact us if you need any
additional information to fill out this form.
Step 1: Student Information
________________________________
_________________________________ ___________________________
Last Name First Name MI HCC Student ID number
Household Information - Fill in the chart on the next page after making a
selection:
Student Financial Aid Office
11400 Robinwood Drive
Hagerstown, MD 21742
finaid@hagerstowncc.edu
FAX: 301-791-9165
2016-2017
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.
