Student Name: _____________________________________________________________________________________
Student ID: _________________________________ OR Social Security Number: X X X – X X – ___ ___ ___ ___
Use this form to report when the family has faced the events of a natural disaster (e.g., tornado, hurricane, flood, mudslide,
etc.), which have impacted the financial resources listed on the FAFSA. Consideration is given to the loss of resources not
covered by insurance.
1. Type of natural disaster: ___________________________________________________________________________
2. Date of occurrence of the natural disaster: _______________________
3. Attach required documentation:
a. 2015 Federal Income Tax Return, including all Schedules
b. Insurance claims along with paid receipts
c. Contracts for repairs from general contractors, if applicable.
Validation Statement: I certify the information provided is complete and true to the best of my knowledge. Furthermore,
I agree to contact the Financial Aid Office at the time there are changes to the situation on which the request for exception
has been founded. I understand that changes made to my student financial aid eligibility based upon the information
provided may affect only the student financial aid received at Indiana Wesleyan University for the 2017-2018 award year.
_________________________________________________________________________ ______________________
Student Signature Date
_________________________________________________________________________ ______________________
Parent Signature (for dependent student only) Date
Mail, email, or fax completed form and supporting documentation to:
Financial Aid Office, IWU-National & Global 1900 West 50
th
Street Marion, IN 46953-9393 indwes.edu
800.621.8667 option 4 765.677.2516 765.677.2030 Fax IWUfinaid@indwes.edu
FINANCIAL AID OFFICE
