SCFIND
Special Circumstances Form
Independent Student
2018-2019
Office of Financial Aid 100 East 8
th
Street PO Box 9000 ▪ Holland, MI 49422-9000
P: 616-395-7765 ▪ F: 616-395-7160 ▪ finaid@hope.edu ▪ hope.edu/financialaid
If your (or your spouse’s) 2018 projected income is expected to be significantly less than that of 2016 or 2017,
provide the requested information. The involuntarily unemployment must be in effect for at least 8 weeks.
Student Name:
Hope College ID Number:
1. Attach a detailed letter explaining
the circumstances affecting your family’s income for the period of
January 1, 2018 to December 31, 2018. Unemployment must not be voluntary.
2. Provide a signed copy of your (and your spouse’s) 2016 and
2017 federal 1040 tax return/W-2 forms.
3. Provide documentation of income estimates (copies of pay stubs, unemployment stubs, verification of
retirement, pensions, Social Security benefits, etc). For loss of employment, also attach a letter from the past
employer on company letterhead confirming loss of employment and the effective date.
4. EXPECTED INCOME IN 2018
Expected gross income from work $____________
Spouse’s expected gross income from work (if you are married) $____________
Net income from business, farm, rentals, royalties, partnerships, estates, trusts, etc. $____________
Unemployment benefits for ____student or ____spouse $____________
Severance or separation pay not included in income from work $____________
Taxable Social Security Benefits $____________
Taxable Pension or Retirement Benefits $____________
Untaxed Social Security Benefits for all family members including SSI disability benefits $____________
Welfare Benefits including TANF but not food stamps or housing assistance $____________
Child Support $____________
Housing, food, & living allowances paid to members of the military, clergy, etc.
(including cash payments and cash value of benefits). $____________
Veteransnoneducation benefits such as Disability, Death Pension, Dependency &
Indemnity Compensation (DIC), and/or VA Educational Work-Study allowances $____________
Worker’s compensation and disability payments $____________
Any other untaxed income and benefits*: Source(s):__________________________ $____________
*EXCLUDE
Workforce Investment Act educational benefits, benefits from flexible spending
arrangements (e.g. cafeteria plans), and combat pay if you are not a tax filer.
5. Child support to be PAID OUT in 2018 because of divorce or separation $____________
NOTE: Be sure to notify us if your circumstances improve. If through a later review of your 2018
documentation we find that you significantly underestimated your 2018 income, the student’s aid
eligibility will be adjusted accordingly the following year.
Student Signature:
_____________________________
Date Signed:
_______________