2014-2015 Household Data Form
(Dependent Student)
Office of Financial Aid
.
Phone: 734.487.0455
.
Fax: 734.487.4281
.
Email: financial_aid@emich.edu
.
Web: www.emich.edu/finaid
DEPHHD
Student ID
Name
As part of the Quality Assurance Verification process, complete and submit this form.
Each person signing this form certifies that all the information reported on it is complete and correct.
The st
udent and at least one parent must sign and date.
Student Signature Date
Parent Signature Date
Full Name Date of birth Relationship to you Name of College
1. Self
Eastern Michigan
University
2.
3.
4.
5.
6.
1. Write the names of all the people in your parent(s)’ household, including:
a.
b.
c.
Yourself (the student).
Your parent(s). If your parents are divorced, indicate the parent you lived with the most during the last 12 months.
If y
ou did not live with one parent more than the other, list the parent who supplied more than half of your
support. Include your step-parent if your parent is remarried. If your legal parents (biological or adopted) are
unmarried but live together, list both parents. Grandparents, foster parents, legal guardians, aunt and uncles are
not considered parents unless they have adopted you.
Your parent(s)’ other children, if your parents will provide more than half of their support between July 1, 2014
and June 30, 2015, or if the children would be required to provide parental information when applying for
federal aid.
d. Other dependents, if they now live with your parent(s), your parent(s) provide more than half of their support
and will continue to provide more than half of their support between July 1, 2014 and June 30, 2015.
2.
Include the date of birth of each person and their relationship to you (the student).
3.
Add the name of the college for any household member who will be enrolled in a degree, diploma, or certificate
program at least half-time between J
uly 1,
2014 and June 30, 2015.
If more space is needed, provide a separate page with your name and EMU ID number at the top.
