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2018-2019

Professional Judgment Appeal

Office of Student Financial Aid

1021 Dulaney Valley Road

Baltimore, Maryland 21204-2794

P: 410-337-6141

F: 410-337-6504

E: finaid@goucher.edu

________________________________ _____________________ _______________________

Student Last Name Student First Name Goucher ID # (or last 4 of SSN)

_________________________ _______________________________________

Best Phone # for Student Student E-Mail

____________________________________ ______________________ ________________________________

Parent Name Best Phone # for Parent Parent E-Mail

On occasion, families experience circumstances that warrant basing their financial aid eligibility on more recent 2017 or

projected 2018 income information, rather than the federally required 2016 “Prior-Prior Year” income information. This

is usually due to a significant recent family event in 2017 or 2018, such as the loss of a job, loss of untaxed income or

benefits, one-time increase of income, death of parent/spouse, or other extraordinary unusual expenses.

If you feel that you have extenuating circumstances not addressed on your 2018-2019 Free Application for Federal

Student Aid (FAFSA), you must complete this form and submit the required documentation to request a reevaluation of

your financial aid eligibility. Appeal requests, if approved, are granted on a one-time, case-by-case basis.

Situations that WILL NOT BE CONSIDERED:

 Voluntary private secondary tuition

 Car payments/insurance

 Personal bankruptcy

 Loss of home equity

 Unemployment for less than 4 months

 Reduction of business income

 Consumer debt

Instructions:

a) Confirm that Goucher has received a 2018-2019 FAFSA, including any required documents. Students can

confirm this by logging in to Net Partner (http://www.goucher.edu/financial-aid/net-partner/) and reviewing

the “Documents” screen.

b) Review pages 2 & 3, and indicate the situation for which you are requesting a professional judgment review.

c) On page 3, type a clear and brief one-page explanation of your situation and sign the Statement of

Understanding. (You may attach a supplemental document if additional space is needed, but please keep

your explanation limited to a single page or less.)

d) Submit this completed appeal request and all required documents to the Office of Student Financial Aid.

Please make only one submission, and submit this form with all documents as a single package.

Response and Turnaround Time:

Professional Judgment Appeals are frequently a committee process. Please allow at least 3 weeks for a response.

During peak processing times (January through April), it may take 4-6 weeks for an appeal to be reviewed by the

committee. The student and parent will be informed of the decision by e-mail to the e-mail addresses indicated above.

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CHECK THE BOX BELOW THAT BEST DESCRIBES YOUR SITUATION

□ Unemployment/Dislocated Worker or Loss of Income after January 1, 2016

Examples include: Termination/layoff from job, significant reduction in work hours or income from work. Loss of child

support or other income/benefit. A reduction of business income, or unemployment for less than 4 months will not be

considered.

Required Documents:

 Signed and dated letter (on company letterhead) from employer listing the following: last date of employment, total

earnings from January 1

of the year in question to the last date of employment.

 Copy of last pay stub.

 Copy of severance/benefits/unemployment eligibility, such as benefits statement or letter from unemployment office.

 Any appropriate documentation of termination of benefits/support/income.

 Statement of expected 2018 wages and unemployment compensation.

 Both 2016 & 2017 IRS Tax Return Transcripts. (Order here: http://www.irs.gov/Individuals/Get-Transcript.) Transcripts are

required even if the IRS Data Retrieval Tool was used.

 Copies of all 2016 & 2017 parent W-2 forms (if dependent) or student & their spouse’s W-2 forms (if independent).

□ Unusual Medical and Dental Expenses

Examples include: Expenses incurred between January 2016 and the present that are not covered by insurance. Unpaid

bills and voluntary medical/dental procedures will not be considered.

2016 Total: $_____________ 2017 Total: $_____________

Required Documents:

 Itemized list of expenses clearly showing only payments specific to the total(s) indicated above. Must be accompanied by

proof of out-of-pocket payment (receipts) made by student, spouse (if married), parents (if dependent).

 Both 2016 & 2017 IRS Tax Return Transcripts. (Order here: http://www.irs.gov/Individuals/Get-Transcript.) Transcripts are

required even if the IRS Data Retrieval Tool was used, and should be showing medical expenses on Schedule A.

□ One-Time, Non-Recurring Increase of Income after January 1, 2016

Required Documents:

 Documentation of the amount and nature of the one-time non-recurring disbursement.

 Both 2016 & 2017 IRS Tax Return Transcripts. (Order here: http://www.irs.gov/Individuals/Get-Transcript.) Transcripts are

required even if the IRS Data Retrieval Tool was used.

□ Recent Separation or Divorce of Parent or Student

Examples include: Parent (if dependent) or student (if independent) marital status changed after the 2018-2019 FAFSA

was filed. Parties in question living in the same house will not be considered.

Required Documents:

 Copy of separation agreement, divorce decree, or substantial evidence (mortgage/lease/utility bill) proving parents (if

dependent) or spouse (if independent) live in separate residences.

 Copy of all parent W-2 forms (if dependent) or student & their spouse’s W-2 forms (if independent).

 For any year with a jointly-filed return, a completed “Parent Tax Separation” form.

 Both 2016 & 2017 IRS Tax Return Transcripts (Order here: http://www.irs.gov/Individuals/Get-Transcript). Transcripts are

required even if the IRS Data Retrieval Tool was used.

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□ Recent Death of Parent or Spouse

Examples include: Parent (if dependent) or spouse (if independent) deceased after the 2018-2019 FAFSA was filed.

Required Documents:

 Copy of death certificate.

 Copy of all parent W-2 forms (if dependent) or student & their spouse’s W-2 forms (if independent).

 For any year with a jointly-filed return, a completed “Parent Tax Separation” form.

 Both 2016 & 2017 IRS Tax Return Transcripts (Order here: http://www.irs.gov/Individuals/Get-Transcript). Transcripts are

required even if the IRS Data Retrieval Tool was used.

TYPE BELOW A CLEAR AND BRIEF EXPLANATION OF YOUR CIRCUMSTANCES

BE SURE TO LIST SPECIFIC DATES

STATEMENT OF UNDERSTANDING

 I/we certify that all of the information provided and the supporting documentation submitted is true and accurate and represents the

situation as described on this form.

 I/we understand that the request will not be considered until all adequate and complete documentation is submitted. In addition, the

Office of Student Financial Aid may require additional documentation in order to document and substantiate the situation.

 I/we understand that the Office of Student Financial Aid will review my request and let me know of the outcome in approximately 3

weeks.

 I/we understand that completion of this form does not guarantee additional aid, and Billing Office payment deadlines and procedures

need to be adhered to during the review process in order to avoid potential late fees.

_____________________________________________ _____________________________

Student Signature Date

_____________________________________________ _____________________________

Parent Signature (Required for students w/ Dependent status.) Date

(ELECTRONIC SIGNATURES NOT ACCEPTED. Please print & sign in ink, then mail, fax, or scan and e-mail.)

Please make one submission, and submit this form with all required documents as a single package.

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